
' ^ <^ ^ /^ <L 



THE EPIDEMIC OF 1847: 



OR, 



BRIEF ACCOUNTS OF THE YELLOAY FEVER, 



THAT PBEVAXLED AT 



New-Orleans, Vicksbnrg, Rodney, Natchez, Ilonston and Covington^ 



COLLECTED AND PUBLISHED 



E. D. FENNER, M. D. 



(Taken from No. 2, Vol. 5, of the New-Orleans Medical and Surgical Journal 
for September, 1848.) 



JOSEPH COHN, PRINTER, 31 POTDBAS STREET. 

1848. 



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PREFATORY REMARKS 



As stated in the title page, the following pamphlet is taken from the 
2d number, vol. 5, of the New Orleans Medical and Surgical Journal, 
(September, 1848.) It is not intended for a treatise on Yellow Fever, 
but merely an imperfect history of a single Epidemic. I had a few extra 
copies struck oif for private distribution, and will take this occasion to add 
some information in relation to the generous beneficence of our Munici- 
pal Councils and the different benevolent societies of New Orleans, 
which the hurry of the moment and frequent interruptions did not allow 
me to enclose in the body of the paper. 

If I am not mistaken, the liberality of this city and its numerous bene- 
volent societies towards that large class of indigent and ignorant people 
to be found in every large city, entitles it to a conspicuous position on 
the scores of Charily and Benevolence. I would not boast of our good 
deeds done to the poor and ajlicted, for ^^ charity vaunteth not;'''' but I 
may be permitted to offer some evidence to those who live abroad and 
know us not, that our city, with all its faults, has^ome redeeming virtues. 
It is thought abroad that we live too high and too fast; that we make 
a mere frolic of life, with all its ills and cares ; but who that 
knows us will deny that we icork hard, that our hearts are ever awake 
to generous sympathies, and that our impetuous feelings are strongly 
tempered with the milk of human kindness ? 

After the epidemic was declared by the Board of Health, the coun- 
cils of the different Municipalities adopted liberal measures for the re- 
lief of the poor. They appointed two physicians and one apothecary 
for each ward, who, with cuppers and bleeders, were to supply all the 
necessary wants of the sick. 

The various benevolent societies at once took active measures for 
the relief the afflicted, and sought them assiduously throughout the city. 

On application to our worthy Mayor, the Hon. A. D. Grossman, and 
to the officers of the most prominent benevolent societies, I obtained the 
following memoranda, which, although not exactly correct, will serve to 
give some idea of the benevolence and munificence of our citizens. 

The following amounts were expended for charitable purposes during 
the epidemic of 1847, viz : 

24 



188 The Epidemic Yellow Fever of 1847. 

By the city of New Orleans, upwards of .... $19,000 

" Howard Association . - 5,919 

" Independent Order of Odd Fellows, about - - 5,000 

" St.Thomas Street Infirmary for widows and orphans 3.000 

" Bartholemew Street Infirmary for immigrants - - 4,009 

" Esplanade Street do ' do - - 3,000 

" Benevolent German Association .... 4,500 

" Hebrew Benevolent Association .... 1,500 

" Firemens' Charitable do - 2,000 



Total .... $47,919 

It is supposed that there were at least five thousand dollars more ex- 
pended for charitable purposes than is here specified. 

The following note from the Secretary of the Howard Association, is 
worthy of being inserted entire : 

" During the epidemic of 1847 the Howard Association had under 
their charge and attention eleven hundred and fifty -four cases, of which 
one hundred and twenty-two died, and one thousand and thirty-two were 
discharged cured. They expended during the prevalence of the epide- 
mic ^/V^^-zji/je hundred and nineteen dollars and fifty-eight cents. 

Many cases presented themselves to members during the epidemic, 
whose situation did not warrant their being taken charge of by the aS' 
sociation, yet who required more or less pecuniary aid and attention, 
and who were taken care of and provided for by individual memhers. 
Of course these are not included in the above statement. 
Very truly, your obedient servant, 

G. W. SHAW, 

To E. D. Fe>n£K. M. D. Secretary Howard Associotion. 

I should not omit to mention in this connection that there were 2811 
patients admitted for yellow fever into the New Orleans Charity Hospital. 
Nor should I omit to mention, injustice to the medical profession of this 
city, that 12,368 patients vere admitted into this institution and treated 
gratuitously during the year 1847. The able house surgeon, whose 
whole time and attention are occupied in the discharge of his onerous 
duties, is the only medical man that receives any compensation for the 
vast amount of professional service rendered at this large hospital. 

If the facts here stated reflect no credit upon the generous citizens of 
New Orleans, then is benevolence a vain illusion, and sordid selfishness 
the only feeling really worth cherishing. New Orleans is a very re- 
markable place in many respects, but perhaps there is nothing for 
which it more justly deserves to be distinguished than its active and 
untiring benevolence. When the stranger visits our city during the 
winter season, he cannot fail to be struck with the extraordinary display 
of industry and energ;- in business everywhere to be seen. If he would 
come ao^ain during the prevalence of an epidemic, when sickness and 
sorrow and death shed a gloom on all around, he could not fail to be 
struck with the contrast, yet he would discover something of the same 
indefatigable energy in the performance of the melancholy duties of 
humanity. The poor sufferer, without money, or friends or acquain- 
tances, remains desolate no longer than his cries for help can be heard. 
As soon as his affliction is ascertained, men and women whom he never 



Dr. Fenner on the Yellow Fever of New Orleans. 1S9 

saw before, and upon whose kindness he has no other claim but that ot* 
simple hwnanity, seek him out wherever he may be, and supply him 
with food and medical aid : they also have him nursed day and night, 
until he either dies, or is set upon liis feet again and prepared to resume 
the duties ol life. How many victims have thus been snatched from the 
jaws of death — how much pain, destitution and anguish have thus been 
relieved is known to but few besides Him who imbued our hearts with 
more or less of benevolence and charity, and enabled us to enjoy " iAe 
luxury of doing good." It often happens that these kind offices are 
bestowed upon beings so degraded as to be incapable of gratitude ; 
but this does not stay the hand of charity or stifle the voice of consola- 
tion. 

I have concluded to republish, in this place, the following editorial 
remarks on the yellow fever of 1S47, which appeared in No. 4, vol. 4, 
of the New Orleans Medical and Surgical Journal. More mature re- 
flection has Koi caused me to alter any conclusion there expressed, as 
will be seen by the subsequent history of the epidemic. 

"YELLOW FEVER. 

"The late Epidemic was probably the most extensive that ever pre- 
vailed in this city. As to its severity and mortality there may be dif- 
ference of opinion. It is impossible to make a correct computation of 
the whole number of cases. Some have estimated it as high as twenty 
or twenty-jive thousand, but we are inclined to think either of these cal- 
culations above the truth. As to the mortality, the reports from the 
cemeteries, as well as they could be obtained by the Board of Health, 
only make out something upwards of 23:^00 from yellow fever ; but this 
is again thought by many to be fav short of the reality. It is much to 
be regretted that we cannot obtain greater precision in such important 
details. The fever raged as an epidemic about two months, and the 
greatest mortality from it was in September, when the number of deaths 
reported to the Board of Health, amounted to 1,044. During the pre- 
A'alence of yellow fever in this city, the most frightful and exaggerated 
reports circulated abroad, but this is nothing unusual. A careful 
collection of all the important facts connected Avith the rise, progress 
and decline of the late epidemic, would form an exceedingly interesting 
memoir, and we have it in contemplation to undertake the task, but it 
must necessarily require a good deal of time and labor. On the other 
hand, it would seem to be almost useless to write anything more on the 
subject of yellow fever. We really believe that the archives of the 
profession already contain every thing that need be said on the subject ; 
and yet the world is but little wiser in regard to it than it was half a 
century ago. Every debateable question which was then discussed, 
in relation to its cause, nature, propagation and treatment, still remains 
undecided ; and, with the exception of a single point {blaclc vo?nit), there 
seems to be as great a diversity of opinion at this moment, as at any 
previous period. We believe the physicians of New Orleans and Mo- 
bile have completely settled the point, that black vomit is a hemorrhage 
from the stomach ; but, doubtless, there are some who do not even admit 
this. Medical are very much like religious controversies : in either 
case, when men have formed and expressed opinions, they seem to shut 



190 The Epidemic Yellow Fever of 1847. 

their eyes against all farther light, and hold on to them with like perti 
nacity. Then why write any thing more upon a subject that has been 
so fully and so ably discussed as yellow fever? It would certainly be 
vain to do so with a view to enlighten or change any who have formed 
and expressed opinions. But is it not our duty to transmit our observa- 
tions to those who are to come after us ? There is scarely any point 
on which some of us are not probably right, and many wrong. With 
oj<r assistance, our successors may fortunately discover the truth on all 
points ; but if they have to bf gin their investigations de novo, the same 
controversies must continue to arise and be endless. They are 
certainly entitled to the benefit of our observations ; and some mas- 
terly mind, yet unborn, may analyse them thoroughly, winnow the grain 
from the chaff, and establish the truth by facts and logic. 

Wo have ourselves seen yellow fever on Jive different years, to 
some extent in all it phases, and have used our best endeavors to study 
it with an unbiassed mind. We have finally been brought to conclu- 
sions by no means novel, yet at variance with many possessing far more 
ability, and v/ho have had a much larger experience. When we pro- 
claim our convictions (if we ever venture to do so), we shall be acquit- 
ted of the charge oi^ presumption, if it appear they only corroborate some 
of the ablest authorities in the profession. 

We will here simpl}' state a few facts relating to the late epidemic, 
which we think can be fully substantiated. 

1. In the spring of the year, intermittent fever prevailed to a great 
extent. 

2. As the season advanced, frequent cases of mild remittent fever 
were to be seen among the intermittents. 

3. Soon after the first of July, severe •remittents became common; 
some of them terminating in hemorrhages and black vomit. Yellow 
Fever was now announced. 

4. The yellow fever raged in Vera Cruz in May and June; the in- 
tercourse between this city and that, at the time, was very great; hun- 
dreds of discharged soldiers were returning from Vera Cruz to this 
place, some of them convalescents from yellow fever, but hardly any 
labouring under if. 

5. On the 22d of June a man, recently from Vera Cruz, died of 
blade vomit at a hotel in Lafayette. He occupied a large room with some 
ten or fifteen other persons. None of these are known to have been 
sick soon afterwards. 

6. The next death from black vomit in Lafayette, occurred about the 
18th July; four or five squares distant from the first. 

7. The first death from black vomit in New Orleans, occurred in an 
Irishman in the rear of the city, near the Charity Hospital. This occured 
about the 1st of July. 

8. The first death from the same that occurred at the Charity Hospi- 
tal, was on the 6th of July. 

y. The next ten deaths at the same hospital were from different parts 
of the city, showing no other connection between each other, except that 
a man and his wife were sick in the same house. 

10. August came — deaths with black vomit were frequent, and yel- 
low fever was pronounced Epidemic. 

11. At this time all the forms of summer fevers might be seen : In- 



Fexxer on the Yellow Fever of New Orleans. 191 

termittents, mild remittents, severe remittents, congestive and yellow. 
Remittent-bilious and yellow fever were predominant. 

12. All the milder attacks of intermittent and remittent fever, if 
neglected or maltreated, assumed the appearance of what is called 
yellou) fever — especially if they terminated /cr/'a//?/. 

13. On the other hand, plain cases of yellow fever, if not promptly 
cured, sometimes tapered off into intermittant fever, and then recovered. 
We saw one instance of this. 

14. In the early stage; of mild attacks of fever, no one would pro- 
nounce a definite diagnosis : if promptly relieved, it was not yellow fe- 
ver : if it terminated yata//?/, all doubt was removed. 

15. At this very time there were cases of what is called congestive 
fever, which terminated fatally in the first or second cliill. 

l(i. September came — and the epidemic raged with its greatest vio- 
lence, affecting to a greater or less extent all ages, sexes, castes and 
conditions, natives and. foreigners. Yet all were not sick : many es- 
caped who had never had the fever, and some who had never spent a 
summer here before. 

17. Many Creoles or natives had it, both white and colored, though 
the disease was evidently milder with these and with unacclimated 
negroes. 

18. A number of persons had the fever for the second and third time, 
and some had it who had escaped several previous epidemics. One of 
the worst cases we saw was an intelligent Irishman, who said he had 
nearly died of it in 1R25, and had lived here ever since, excepting 17 
months spent in Mobile. He recovered, after having hemorrhage from 
the mouth and turning very yellow. 

19. Recent settlers in the city, especially the poorer class, evidently 
suffered the most, above all, those who were much exposed to the sun. 

20. The fever prevailed throughout the entire limits of the city and 
Lafayette, which lies on the river, iramediately above ; and to the great- 
est extent, wherever were to be found the greatest number of poor and 
unacclimated people. The extent and violence of the disease seemed 
to be governed more by the last mentioned fact, than by any thing else 
pertaining to the different localities. 

21. Many persons who left the city late in the summer, were attacked 
on their journey ; and some who came in late were attacked within a 
very short time after their arrival, especially if much exposed to the sun. 

22. October came — and, on its approach, what is called yellow fever 
most rapidly declined ; the monthly number of deaths having fallen from 
1044 down to 198. The comparative number of intermittents now 
began to increase again, and when, neglected or maltreated, many of 
them ran into yellow fever : if promptly relieved, of course they were 
but simple intermittents. 

23. During the month of October the weather was mild, fair and 
beautiful, hardly approaching witliin 20 degrees of frost. 

24. November came — and with it our travelling citizens, together 
with the vast number of persons who annually come to New Orleans 
to do business in the winter season. The papers had announced that 
the epidemic had disappeared, and every body returned to their homes 
and avocations. But yellow fever was not yet extinct ; sporadic cases 
were to be seen in different parts of the city. The deaths from it re- 



192 The Epidemic Yellow Fever of 1S47. 

ported tor tliis month were 12. The weather continued so warm for the 
tirst half of the month as to render fires almost useless. The city was so 
rapid)}' filled as to give rise to some apprehension that the epidemic 
would be renewed ; but such was not the case. It had run its career 
and was gradually dying away. 

25. During this month European emigrants commenced pouring into 
our city, bringing with them theyr fatal companion typhoid or ship fever. 
It was most curious to observe with what facility the subjects of this 
fever assumed the characteristic symptoms of yellow fever after enter- 
ing the Mississippi riv^er. Some who had escaped sickness during the 
long voyage l)y sea, were attacked soon after entering the city, and, 
going into hospital, in seven or eight days presented hemorrhage from 
the gums and yellowness of the skin. One or two cases terminated 
fatally with black vomit. Through the politeness of Dr. Ker, we were 
shown several of these cases at the Marine Hospital. 

26. On the 25th of November the weather suddenly turned very cold, 
and on the 2fith and 27th there was ice in the gutters. On the 28th, 
white frost. 

27. The last death from yellow fever was reported in the weekly 
report of the Board of Health for the 25th December. There were 
ten deaths from yellow fever in this month. 

28. Yellow fever prevailed this year at the following places, viz ; 
Mobile, Galveston, Alexandria, (on Red river) Vicksburg and Rodney, 
on the Mississippi river ; all having constant communication with New 
Orleans. There were also some cases at Baton Rouge and Plaque- 
mine ; whereas Natchez, Grand Gulf, and, we believe, St. Francisville 
escaped. 

29 Quarantine was maintained in Natchez and Vicksburg. The 
former escaped and the latter had the fever.* Whereas, of the interme- 
diate towns between those places, Rodney, next to Natchez, was severely 
scourged, whilst Grand Gulf, next to Vicksburg, escaped. We have 
addressed a circidar to physicians residing in each of these places, and 
hope to obtain from them some interesting intelligence relative to the 
matter. 

Such are some of the prominent facts concerning the late epidemic, 
which, we think, can be fully substantiated by good evidence. There 
are many others of great importance, which a minute history of it would 
display in their proper light. The whole would give rise to deductions 
which would probably vary according to the diversity of intellect by 
which they were examined." F. 

* I mean that Natchez escaped an epidemic ; not entirely, as was supposed by 
Dr. C. H. Stone and Dr. W. P. Hort. F. 



THE EPIDEMIC OF 1847 : 
Or Brief Accounts of the Yellow Fever that prevailed at New Orleans, 
Vicksburg, Rodney, Natchez, Houston, ( Texas,) and Covington, 
Louisiana. Collected and published by E. D. Feniver, M. D., of 
New Orleans. 

Under this title I shall lay before the Profession such observations as 
I could hastily throw together, in addition to those I gave under the head 
of " Health of the City " in the last volume of this Journal, together 
with those obligingly furnished me by Drs. B. J. Hicks, of Vicksburg, 
W. G. Williams, of Rodney, W. McCraven, of Houston, S. A. Cart- 
Wright of Natchez, and J. Gilpin, of Covington, La. 

Wishing to obtain as full an account as possible of the late epidemic 
in the lower part of the Mississippi Valley, I took the liberty of address- 
ing the above named gentlemen (as well as several others who did not 
reply) who gave me the papers that follow. They will please accept 
my grateful acknowledgements for their kind attention to my request, 
and I doubt not, their favours will be duly appreciated by the Profession 
at large. To all of them, except Dr. Gilpin, I addressed a set of inter- 
rogatories which I thought would cover the grounds of inquiry. Dr. 
Gilpin's letter was published in the November number of this Journal, 
but I deem it proper to republish it in this connection, by way of com- 
pleting the history of the epidemic. 

Dr. Lewis, of Mobile, did me the favour to send over a hasty sketch, 
when I expected to publish in March last, but afterwards concluded to 
draw up a more elaborate report of the fever at Mobile, which may 
bo found in the last number of this Journal. 

Dr. Ashbel Smith, of Galveston, Texas, also promised me a com- 
munication, but afterwards determined to report more fully in a different 
wa}^ which I hope will soon see the light. We shall thus, amongst us 
all, I trust, make up a pretty good history of the epidemic as it appeared 
at different places, which is the sole object I have had in view. 

I. — The Yellow Fever of New Orleans. 
I sincerely Avish that some abler hand had undertaken that portion of 
the task which relates to New Orleans, and I have postponed writing, 
partly under the hope that it would be, but seeing no prospect of it, I 
have determined to come forward and again throw myself on the indul- 
gence of the Profession, as it would be a reproach to us all for such an 
epidemic as that of 1847 to pass without farther notice than the brief 
editorials ofa periodical. I shall, therefore, endeavour to somewhat en- 
large the historical account, though I must necessarily be brief at this 
late day. This publication should have been made in the March num- 
ber of this Journal ; but, after laying aside my editorial labors, I really 
felt so much jaded in mind that 1 could not summon suflicient energy 
to undertake the task. The historical sketch of the epidemic in this city 
which I am now about to make, must necessarily be very imperfect — 
in fact, confined pretty much to my own observations, as I have not been 
able to obtain as much information as I should desire from the phy- 
sicians of the city, nor has anything on the subject emanated from 
either of our Medical societies. I shall take up the most salient points 
as they occur to my mind. In the numbers of this Journal for Septem- 
ber, November and January last, under the head of " Health of the 



194 The Ej)idemic Yellow Fever of IB'il. 

City," may be found some editorial remarks on the epidemic, relative to 
its beginning, progress, extent, mortality, die, to which I would refer 
the reader. 

Meteorology of the year. — I have compiled from the bi-monthly me- 
teorological reports furnished to this Journal by Mr. D. T. Lillie, the 
following abstract, which will give a good genei'al idea of the weather 
throughout the year : 

January and February. — Weather cold, wet and changeable. 

Thermometer ranged from . . . 77.5, to 30.° 

Barometer " " ... 30.55, to 29.72. 

Number of rainy days .... 16. 

Quantity of rain (inches) . . . 17.960. 
March and April. — Weather very variable and bad — spring unusually late. 

Thermometer ranged from . . . 88.3, to 40 

Barometer " " ... 30.50, to 29.72. 

Number of rainy days .... 13. 

Quantity of rain 14.341. 

f May and June. — Weather variable — May cool, June hot. 

Thermometer ranged from . . . 90.5, to 63.5. 

Barometer " "... 30 26, to 30. 

Number of rainy days .... 21. 

Quantity of rain 13.176. 

July and August. — Rather cool, very wet, much thunder and lightning. 

Thermometer ranged from . . . 91.6, to 71. 

Barometer " " ... 30.24, to 29.87. 

Number of rainy days .... 30. 

Quantity of rain 22.265. 

September and October. — Weather fair and beautiful. 

Thermometer ranged from . . . 89.5, to 52. 

Barometer " " ... 30.38, to 29.91. 

Number of rainy days . . . . 17. 

Quantity of rain 10.435. 

November and December. — Weather very changeable. 

Thermometer ranged from ... 83, to 29. 

Barometer " " ... 80.50, to 29.88. 

Number of rainy days .... 12. 

Quantity of rain 19.625. 

Whole number of rainy days during the year, 106. 

Whole quantity of rain, 21% inches. 

It will thus be seen that the weather throughout the year was for the 
most part cool, changeable and remarkably wet. The quantity of rain 
that fell is quite extraordinary. The wettest month was July, during 
which it rained 22 days. In June it rained 17 days — in August, 8 days. 

Intercourse with Vera Crui. — In the month of March, the city of 
Vera Cruz, (considered to be the favorite abode of yellow fever,) was 
taken by our invading army under the command ol Gen. Scott, and 
from that time the intercourse between this city and that has been con- 
stant and most extensive. As the main body of our army proceeded from 
Vera Cruz on towards the city of Mexico, everything in the w^ay of men, 
arms, ammunition and provisions had necessarily to pass through the 
former place. Throughout the year, new regiments continued to go 
to this line of operations, and the discharged, the sick and disabled 
were constantly returning to this place. From the best information I 
could procure, Vera Cruz has never been entirely free from yellow 
fever since it fell into our hands ; yet, notwithstanding the large num- 



Dr. Fenner on the Yellow Fever of New Orleans. 195 

ber of sick and discharged soldiers that returned from that place to this, 
during the spring and summer of 1847, very tew cases of that disease 
were brought over, and the most careful inquiry I could make has not 
brought to light a single instance in which it was communicated directly 
to any person in this city or Lafayette. The nearest approach to it oc- 
cured in the following cases, the notes of which were given to me by 
Dr. Carpenter. 

Case 1st. — J. Strider, from Vera Cruz, attached to the Quarter- 
master's service — camo from Vera Cruz on the steamer "Galveston," 
about the 17th June, and landed at Lafayette — had all the characteris- 
tics of yellow fever, and died with Mark vomit on the 22d of June. 
Dr. C. got this note from Dr. Thorpe, who attended the man. I have 
not been able to see Dr. Thorpe, since the occurrence, but ascertained 
from Dr. Sunderland, who practises in Lafayette, that the man had laid 
sick in a large public room at a hotel in which a number of persons 
slept — that on inquiry, he never heard of any of them contracting the 
fever — in fact that the next case of yellow fever that occurred in La- 
fayette, happened in a person who lived four squares from this hotel, and 
nearly a month after Strider died. About the '25th of July the epidem- 
ic broke out in Lafayette and raged severely. 

Case 2d. — Theodore Bell, musician to the 5th infantry, entered (he 
Maison de Sanle, June 17th. Had just arrived from Vera Cruz, on 
the steamer " Massachusetts" — had been in the hospital at Vera Cruz, 
in bad health — was attacked with fever on the voyage — had fever when 
he entered hospital here, with yellowness of the skin and eyes dsc. 
On the 2d day after admission had hemorrhage from gums and fauces 
— 'became very yellow — vomited a dark colored matter — urine dark — 
died on the 27th of June. 

I saw this case, together with several other physicians, none of whom 
seemed satisfied that it was a decided case of Yellow Fever. The 
truth is, the man had long been sick with diarrhoea, which I have be- 
fore seen terminate fatally with hemorrhage and jaundice. I never 
heard of any sort of connection between this case and the next of yel- 
low fever admitted into this hospital, which occurred on the 20th July. 

Although yellow fever was prevailing at Vera Cruz at this time to a 
moderate extent, there were really hardly any cases brought to this city 
among the returning soldiers. Their chief disease was chronic diar- 
rhoea. In the number of this Journal for July 1847, was published a 
letter from assistant surgeon Charles McCormick, medical director, sta- 
tioned at this place, from which is taken the following extract relating 
to the sickness amongst the returning soldiers and at Vera Cruz. 

''New Orleans^ July 22, 1847. 
Gentlemen : — At your request I furnish the following information in 
relation to the sick and wounded of the army : On the Kith instant the 
steamship Massachusetts arrived from Vera Cruz, having on board 163 
sick from the army. On the 21st the steamer James L. Day arrived, 
having on board 120 sick men, also from the army and Vera Cruz. 
The military hospital at the barracks being nearly full, as many of the 



196 The Epidemic Yellow Fever of 1847. 

men were received there, as Surgeon R. C. Wood deemed it proper to 
take in, with a view to their proper comfort and accommodation. The 
balance were placed in Dr. Luzenberg's and Stone, Kennedy & Carpen- 
ter's Hospital ; and after these two hospitals had been filled, about 
thirty-nine were sent to the Charity Hospital, where they were received 
and made as comfortable as possible. In relation to yellow feA'er in 
Vera Cruz, Dr. Laub, of the U. S. Army, writes me : " We have a 
great many sick, and our list increasing ; among them some cases of 
yellow fever, though as yet it cannot be said to have become epidemic. 
No doubt, however, in a short time we shall have it in all its virulence, 
at least if the accounts given of it by many here are to be depended 
on." 

"Dr. Barton, U. S. Army, says:" 'Vomito increasing — but exactly 
what we are accustomed to in New Orleans — its type in some instances 
severe.' 

" Dr. Barnes, who was employed and went from this city to Vera 
Cruz to assist in the military hospital, says :" ' The yellow fever pre- 
>'ails to a considerable extent in Dr. Porter's Hospital. There are 
about 350 in it and in Dr. Laub's, of the 1st infantry, and some 82 
quarter-master's men. (Of course, the Doctor means, of all cases. F.) 
But it has not the malignancy I was led to expect it would present here. 
The most of the cases I have seen present more the appearance of re- 
mittent than of yellow fever ; and were it not for the brilliant and red 
appearance of the eye, and above all, the termination of the cases in 
black vomit, it would be thought, in the country, remittent fever. They 
either run their course with great rapidity, or improve. I have seen 
but few cases of the typhoid fever which was seen last summer in near- 
ly all of the patients suffering from it in the N. O. Charity Hospital, and 
in which it was almost universally fatal. The fever is very high for the 
first 24 or 36 hours ; remission then takes place, of variable degree 
and duration, and mounts up again, and again remits, until the 5th or 
8th day, when the patient either throws up black vomit or is left in a 
state of great exhaustion, free from fever and convalesces slowly &c. 
********** 

* * * « j)j.^ Dashiell states a case of yellow fever that occurred 
previous to his departure from Vera Cruz, of a man in good health who 
was getting shaved in a barber's shop, and who commenced at once to 
throw up the hlack vomit, expiring (as a matter of course) shortly af- 
terwards. This comprises the latest medical information I have receiv- 
ed from that portion of the army in the direction of Vera Cruz. 
Very Respectfully, 

CHARLES McCORMICK, 

Ass't. Surg. U. S. Army." 

About the 1st of July an arrangement was efTected by which all sick 
soldiers were taken to Dr. Luzenberg's private hospital, situated on the 
Pontchartrain railroad, about 2J miles from the centre of the city. At 
this beautiful and commodious establishment they enjoyed every com- 
fort and attention that could be desired. There was probably an aver- 
age of 500 sick soldiers at this hospital from July to December. As 
before stated, amongst the large number of disabled soldiers returned 



Dr. Fenner on the Yellow Fever of New Orleans. 197 

from Mexico, there were very few cases of yellow fever. Dr. Luzen- 
berg's hospital consists of three extensive buildings on the same lot, 
but a little removed from each other. The grounds are spacious and 
ornamented with flourishing and beautiful shrubbury. The establish- 
ment is in the suburbs, and quite retired from the populous part of the 
city. During the prevalence of epidemics a considerable number of 
yellow fever patients are generally received into this institution, and 
this year they were confined to one of the buildings, (the centre.) At 
tRis hospital the sick and wounded soldiers were entertained during this 
sickly summer and autumn, without communicaiing or receiving yellow 
fever, so far as I have been able to ascertain. How could this have 
happened, if the disease were either contagious or infectious? These 
soldiers were mostly from the interior of the country — probably not one 
in a hundred of them had ever suffered or seen yellow fever. 

The vessels at this time plying between this city and Vera Cruz 
were chiefly engaged in the transportation of men, horses and provis- 
ions, and their place of landing was Lafayette; yet the epidemic was 
not declared there as soon as it was in this city.* 

So much for the effect of our intercourse with the pestiferous city of 
Vera Cruz. From the time that city succumbed to our victorious 
arms, predictions were rife that a severe epidemic would follow as a 
natural consequence. I am aware that the impression has gone abi'oad 
that our sickness last year was mainly attributable to this source ; but, 
from the best information I have been able to obtain in relation to it, I 
am compelled to think such a conclusion altogether unwarrantable. 

Sanatory condition of the City. — The city was, perhaps, never in a 
more filthy condition than it was throughout this year. Notwithstand- 
ing the admonitions of the Board of Health and the remarks on the con- 
dition of the streets offered by the editors of this Journal and the news- 
paper press, from time to time, our city authorities took no precautions 
against sickness. Even the customary very imperfect measures 
for cleaning the streets were more neglected than usual. New Orleans 
is notoriously a dirty place, but in 1847 it may be said to have luxuriated 
in filth. In the month of April, the river rose very high, and for a week 
or two, poured through the cross streets into the swamp in the rear of 
the city. At the highest stage of water, a crevasse occured opposite the 
city, in the little town of Algiers. A vast quantity of water escaped in 
that direction, before the crevasse was repaired. After this, stagnant 
water remained upon the Bingaman race-track until it disappeared by 
evaporation. Nothing more need be said about the hygienic condition 
of the city, as it was about as bad as it could be. 

Commencement of the Epidemic. — We had the customary diseases 
up to the month of June, such as intermittent, remittent and typhoid 
fevers, diarrhoea, dysentery, and besides, an extraordinary amount of 
typhus or ship fever. This latter disease prevailed chiefly amongst the 



* The distant reader should be informed that Lafayette adjoins New Orleans 
immediately above, and contains some 8 or 10,000 inhabitants. 



198 The Epidemic Yellow Fever of 1847. 

European emigrants, an extraordinary number of whom came over this 
spring. During the months of April, May, and June, 641 cases of ship 
fever were admitted into the Charity Hospital alone. June is generally the 
healthiest month of the year in New Orleans. Our citizens enjoyed their 
customary exemption from sickness during this month, with the excep- 
tion of a mild influenza which prevailed to some extent immediately be- 
fore yellow fever made its appearance. 

As usual, the epedemic fevers gradually assumed a graver type, as the 
season advanced. Remittent bilious fever increased considerably in 
June, and soon after the 1st of July, was merged into yellow fever. 
Some of the severe cases of remittent fever resembled yellow fever so 
much that they would have unquestionably been pronounced such, if 
they had occurred a month later. Indeed, cases much less strongly 
marked than some of these, were pronounced yellow fever during the 
prevalence of the epidemic. But it is customary here not to call any 
thing originating here yelloio fever, early in the season, unless black 
vomit is seen, or has occurred. If the patient should have recently ar- 
rived from Vera Cruz or Havana, he will l)e pronounced yellow fever, no 
matter how light his symptoms. 

Let us now see how the disease began and when it was declared to 
be epidemic by the Board of Health, 'i'he term epidemic is used in 
this city as much to designate the amount of yellow fever, as anything 
else. Hence we sometimes hear people say — " we have a good 
many cases of yellow fever, Ijut it is not epidemic." Also the in- 
quiries — "have you any yellow fever? "Yes." "Is it epidemic? 
" No, or yes" — as the case may be. From such remarks it may also 
be inferred that yellow fever, in its early stages, does not always 
present such peculiar and decided symptoms as invariably distinguish 
the disease. 

So far as I could ascertain, the following is the first case of black 
vomit that occurred this season. The case was reported to me by Dr. 
A. Mercier. 

An Irish drayman, who said he had lived in New Orleans about five 
months — residence near St. Mary's Market, in the upper part of the city 
— whilst on a visit to a friend who resided on Adeline street, three 
squares back of the Charity Hospital, was attacked with fever on the 
21st of June. He soon became so ill that his friend would not permit 
him to return home, but sent for Dr. Mercier. Dr. Mercier found him 
laboring under high fever, with the usual pains in the head, back &c., 
but as it \vas so early in the season, he did not suspect yellow fever — 
thought it only an attack of bilious remittent. He bled him copiously 
and continued to treat him, but the fever proved very obstinate, and 
about the 11th day began to look so much like yellow fever that he in- 
vited Dr. Landraux to see the case. Dr. Landraux concurred Avith Dr. 
Mercier that it was now a decided case of Yellow fever, with every 
prospect of death by black vomit. He continued to get worse — turned 
yellow — had hemorrhage from the gums — threw up black vomit for ten 
hours before death, and died on the 3d of July, the 14th day of illness. 

The following is a list of the first ten cases admitted into the 
Charity Hospital, made out by myself at the time of occur- 



Dr. Fenner 071 the Yclloic Fever of New Orleans. 199 

rence ; or rather, this is an abstract from notes taken by myself and 
some of the attending physicians. The main object in view was to as- 
certain in what parts of the city they occurred and whether there was 
any connection between them. 

First cases of yellow fever at the Charily Hospital, in 1847. 

Case \st. — Wilhelm Renners, age 28 years — a seaman, native of 
Prussia — arrived here from Liverpool, about 5 years ago — has lived in 
New Orleans ever since, mostly in the Third Municipality or lower 
part of the city — worked on the levee loading and unloading vessels — 
went to Brazos Santiago and returned about 15 weeks since. Entered 
the hospital on the 5th July, had then been sick with tever six days. 
Commenced throwing up black vomit on the evening of the sixth and 
died on the 7th. An unquestionable case. 

Case 2d. — John Gooder, Englishman — age 19 years — a steamboat 
man — last from Halifax, Nova Scotia — in New Orleans 12 months. 
Entered the hospital on the 4th July, then sick 4 days — died with black 
vomit on the 8th. Unquestionable Case. 

Case 3d. — Christopher Muhl, a German — age 27 years — a cooper 
by trade — arrived in this city on the 12th April 1847 — had suffered from 
diarrhaea for a month before getting here. Lived in the lower part of 
the city. Has been admitted and discharged from the hospital on three 
different occasions on account of his bowel-complaint. Was admitted 
last on the 3d July, having fever, but complaining chiefly of diarrhcEa. 
Took astringent medicines, which stopped the diarrhoea and he became 
much worse — on the morning of the 8th commenced throwing up his 
food and drinks, and at 7 P. M. black vomit appeared — this continued 
until the 10th at 10 o'clock A. M., when he died. 

N. B. The postmortem examination of this case created some 
doubts as to its being genuine yellow fever. No black vomit was found 
in the stomach or intestines. The gastro-intestinal mucous membrane 
throughout was infiltrated with limpid serum — it was in a dropsical con- 
dition — that of the stomach was of a rose color — there was a slight 
abrasion near each of the orifices of the stomach, not larger than the 
finger nail, but no appearance of blood about them. There was about 
2 quarts of clear serum in the peritoneal sack — lymphy deposits over 
the surface of the liver, spleen and heart. Adhesions between the 
heart and pericardium, also between the lungs and ribs. The liver and 
spleen were very dense, the latter enlarged. The kidneys were granul- 
ated ; the left greatly hypertrophied, the right atrophied. The blood 
coagulated readily. The body and eyes were very slightly yellow. 
Several experienced physicians who witnessed this examination con- 
cluded that the case was not yellow fever, but chronic gastro-enteritis 
terminating in hemorrhage, alias black vomit.. 

Case 4</i.— Christopher Antoine — a German weaver — age 48 years 
— arrived from Havre, 6 months since. Residence on St. Phillip 
street — entered hospital July 10th, then sick 7 days — died on the 11th 
with hemorrhage from the mouth and anus, but no black vomit. The 
corps became yellow. A(o doubts expressed about the case. 



200 The Epidemic Yellow Fever of IS'l'i , 

Case oth. — G. W. Sherman — age 25 years — has been in New Or- 
leans the last 5 years — thought he had yellow fever three or four 
years ago — lived in the Third Municipality — business on the levee, 
loading and unloading steamboats and ships. Entered hospital on 
the 10th July — said he had then been sick about 10 days. Com- 
plained of great restlessness, pain in the head and back, sick stomach 
— eyes injected, skin yellow — died on the 11th, with convulsions. 
The corps was very yellow, lower part purple. 

This man did not throw up black vomit, but there was no doubt as 
to its being yellow fever. 

Case Olh. — Susan Antoine, age 49 years, the wife of case No. 4, 
residence same; entered hospital July 11th, then sick with fever 8 
days — eyes injected, skin yellow, slight hemorrhage from gums. This 
patient was convalescent on the 13th and recovered. 

Case 7th. — William Rose, seaman, native of Canada, aged 22 years; 
a cook and steward on board the schooner " Bello," at present en- 
gaged in the U. S. Service, arrived here from the mouth of the Rio 
Grande, on the 29th of June, and remained on board the schooner 
across the river at Algiers ; was exposed to the sun a good deal. 
Was attacked with violent headache, fever and sick stomach about 11 
o'clock A. M., July the Gth ; says he took five or six drops of laud- 
anum. On the 7th the captain of the vessel gave him five purgative 
pills which operated very severely ; he continued to vomit. The cap- 
tain then gave him an emetic which vomited him severely. Says he 
continued to vomit and have fever and headache until Friday the 9th, 
when the ejecta were so acid and acrid as almost to excoriate the fauces. 
On Saturday the 10th he commenced throwing up black vomit. He was 
brought to the Charity Hospital on Sunday morning, July 11th. I saw 
him with Dr. Cross at 5 P. M. Found him asleep, as soon as he 
awoke, commenced retching — pulse 84 and soft ; bowels open ; no 
urine for two days; skin yellow; eyes muddy yellow; intellect clear; 
surface cool and dry; tongue slightly furred; but little thirst. Con- 
tinued to throw up black vomit and died about 3 o'clock at night. An 
unquestionable case of yellow fever. 

Case 8th. — James Cooper, an Englishman, aged 25, a seaman. 
Says he came from Vera Cruz about 3 months ago ; is subject to 
epilepsy ; when asked how long he had been sick ; said three weeks, 
when he had the last fit ; never felt well since. Entered the hospital 
on the 17th July and died with black vomit on the 19th July. The 
corpse turned very yellow. No autopsy. As yellow fever was not 
suspected when he came in, his particular residence in the city was not 
ascertained. 

Case 9th. — Manual Davan, Spaniard, laborer ; has lived about New 
Orleans mostly for the last two years, but never spent a summer here. 
Last residence in the Third Municipality. Entered the hospital on 
the 15th July ; then extremely low ; hemorrhage from mouth, hiccup, 
very yellow, no urine ; been sick 4 days. Died at night, with black 
vomit ; after death the stomach was found to contain black vomit. 



Benner on the Yellow Fever of New Orleans. 201 

Pase Will. — Adam Keepferler, a German laborer, aged 24 years ; in 
New Orleans 6 months; lived near St. Mary's Market; worked sometimes 
on the levee and sometimes in the swamp back of the city. Entered 
hospital July 15th; said he had been sick seven or eight days. On 
the 16th I found him clear of fever; intellect clear; does not sleep 
■vYGii ; has thirst, pain in the stomach, yellow skin, hemorrhage from 
gums; bowels open, urine free, pulse 80. July 17th, better; skin 
cool and moist, but very yellow ; less hemorrhage ; rather restless, but 
no particular pain ; stomach quiet and easy. 

This man continued very weak for some days ; suffered very much 
from inflammation of both parotid glands, but they were relieved with- 
out suppuration ; he convalesced slowly and was discharged on the 
25th of July. 

From this time admissions for yellow fever increased daily and 
soon became numerous. 

On the 12th of July the Board of Health report the whole number of 
interments in the city, for the week ending July 10th, as havhig been 
138, and make the first public announcement of the appearance of yel- 
low fever. The following extract is taken from their proceedings, pub- 
lished in the papers of the day : 

"Meeting of the Board of Health, Monday, July 12lh, 1847. 
****** pjyg deaths from yellow fever have occurred in the 
Charity Hospital, and two or three cases are still under treatment in that insti- 
tution. They appear to have originated in the city ; and no facts have come 
to light to prove any connection between these cases and the fever prevailing 
at Vera Cruz, or other foreign ports. 

(Signed) W. P. HORT, Chairman. 
A. Hester, Secretary." 

In their report for the week ending July 17th, the Board of Health 
say the whole number of interments was 143; of which 6 died of yel- 
low fever. 

In their next weekly report, up to July 24th, the whole number of 
deaths reported, is 131 ; of which 16 were from yellow fever. 

In their next report for the week ending July 31st the whole num- 
ber of deaths is 177; of which 47 were from yellow fever. In this 
report, the Board announce the approach of the epidemic, as follows : 

"Board of Health, August 2, 1847. ' 
" It having been well established by the observations of the physicians of the 
city, that the yellow fever is now prevailing in nearly every part of it, and 
further appearing by the reports of the medical men, of the public and private 
hospitals, and of the cemeteries, that the cases of this disease have been numer- 
ous during the past week, and forty seven thereof fatal — it becomes the duty of 
this Board to apprise the public, and particularly the unacclimated, that we 
are on the eve of an epidemic, that the latter may prepare to absent themselves 
in time, and avoid such exposure and imprudence as may increase their sus- 
ceptibility to the disease. (Signed) WARREN STONE, Chairman. 
A. Hestee, Secretary." 

From this time daily reports were published in the city newspapers, 
and the deathsyrom yellow fever alone during the next week were 133. 
The disease and the mortality continued to increase, and pervaded all 



202 The Epidemic Yellow Fever of 1847. 

ranks of society throughout the whole extent of the city. The great- 
est mortality occurred during the week ending the 5th of September, 
when the deaths, from yellow fever alone, amounted to 435. From this 
time the disease gradually declined, as will appear from the following ex- 
tract from the November number of this Journal, in an editorial upon 
the " health of the city," written by my then colleague, Dr. Hester. 
Dr. Hester says : " After much labor and great care, we have com- 
piled from the published reports of the Board of Health, the following 
statement which will speak for itself. 

Interments in the city of Neic Orleans, from the ^d of July to the IStk 
October, 1847, inclusive. 

For the week ending 10th July — Total 

" " 17th " " 

" " 24th " " 

« " 31st " " 

" " 8th Aug. " 

« " 15th " " 

" " 22d " " 

« " 29th " " 

« " 5th Sept. " 

" " 12th " " 

" " 19th " " 

« " 26th " " 

" " 3d Oct. " 

" " 10th " " 

From the 10th to 18th " " 

Total, 3,990. Of yellow fever, 2,241 

Interments in the city of Lafayette, from July 26th to September 21st, 
inclusive — total, 793 ; of which 498 were from yellow fevei*. Thus 
making the total deaths of all diseases in both cities, 4,873 ; of which 
2,739 were from yellow fever." 

Termination of the Epidemic. — On the 18th of October the Board 
of Health published the following statement : 

"■Meeting of the Board of Health, October I8lh, 1847. 
The Board of Health feels authorized to make the announcement that the 
yellow fever, which has been prevailing as an epidemic, has for some time ceas- 
ed to exhibit this character, and as such has now disappeared. At the same 
time it is proper to state, that the sporadic cases, which have always been seen 
for one or two months after the disappearance of epidemic yellow fever, must 
still be expected to prevail. (Signed) WARREN STONE, Chairman. 
VV. T. Brent, Secretary pro tern." 

Sporadic cases did occur until very late. The number of deaths 
from yellow fever reported to the Board of Health, for November, was 
12 ; and for December 10. The last death reported from yellow fever, 
occurred in the week ending on the 25th of December. 

The weather for the first half of November was so very warm, and 
the city was so rapidly filled up with returning inhabitants, as to give 
rise to some apprehension that the epidemic would be revived. But 



138- 


-of 


yellow fever 


5 


143 


(( 


(( 


6 


131 


(( 


t( 


16 


177 


(( 


a 


47 


263 


(; 


a 


118 


353 


(( 


a 


197 


432 


(( 


(i 


322 


461 


(( 


ii 


328 


540 


u 


a 


435 


491 


(t 


li 


355 


257 


(( 


n 


169 


181 


(( 


ii 


85 


149 


ii 


a 


61 


126 


a 


u 


44 


148 


u 


4i 


53 



Fenner on the Yellow Fever of New Orleans. ^03 

such was not the case ; it had run its career and gradually died away. 
Yellow fever seldom prevails at this place as an epidemic longer than 
about two months. It then subsides, whether there be frost or not. The 
above announcement of the Board of Health Avas made more than a 
month before the appearance of frost, which was not seen here until the 
26th of November. At the equinox we had rain and a pretty smart 
blow for a single day, but it then cleared oft" warm and continued so, 
with but slight deviation, for two months. So mvich for the rise, pro- 
gress and decline of the epidemic. We have yet to speak of its 
general character, extent and mortality, and then to offer some special 
observations. 

General Character of the Epidetnic. — As there has been no exten- 
sive or severe epidemic (excepting this) in New Orleans, since 1641, 
when I came here to live, I have had to refer to physicians of much 
longer residence, for a comparison between this and others. All th^ 
older physicians with whom I have conversed on the subject seemed to 
agree that the epidemic of 1847 was the. most extensive that ever prevail- 
ed in New Orleans, but was not so malignant or severe as that of 1841 or 
1839. This conclusion appears to be strongly supported by statistics 
obtained from the Charity Hospital and the Maison de Sanfd at both of 
which institutions the mortality from yellow fever was less than was 
ever known before. 

At the commencement of the epidemic, the attacks were generally 
so mild and yielded so readily tp treatment, that there was considerable 
discussion as to whether it was really yellow fever that prevailed. It 
was not very long, however, before this point was universally conceded, 
and towards the 1st of September the disease became very malignant. 

In previous numbers of this Journal, I have frequently alluded to the 
want of precision amongst the physicians of this city, as to the particu- 
lar symptoms which characterize yellow fever. Hence the doubt and 
uncertainty so often witnessed when required to pronounce upon a 
case. Doubtless there are numerous cases so strongly marked from 
the onset, as to admit of no hesitation whatever ; but there are others, 
with symptoms so mild and progress so insidious, as to elude all suspi- 
cion, until patient and physician are alike startled by the sudden ap- 
pearance of some fatal sign. Many cases cannot be distinguished 
from ordinary remittent and even intermittent fever, unless they ap- 
proach a fatal termination. Some cases admit of doubt in the earlier 
stages — if promptly relieved, there is doubt after they recover — but if 
these same doubtful cases be neglected or maltreated and terminate 
fatally, they then generally become plain enough. How often do we 
find Doctors differing about the character of a case of fever, and at last 
see their decision directed more by the attendant circumstances, than by 
any real value of the symptoms per se. If the case occur when yellow 
fever is common, the slightest similiUide may influence the judgment; 
but if it should happen to be the first suspicious case of the season, or 
should occur unusually late, or out of season entirely, then the strong, 
est evidence, such as black vomit, hemorrhage, <^c., will be required to 
settle the question. In the autumn of 1846, the members of the 
Board of Health (all physicians) differed so much about the character 

26 



204 The Epidemic Yellow Fever of 1847. 

of the prevailing fever, that a committee of three was appointed to 
examine the vizards of the Charity Hospital and report the number of 
cases of yellow fever to be found there. In the performance of this 
duty, one member of the committee gave rather a reluctant assent to 
the discovery of only 6 or 8 cases, whilst another thought there were 
about 20 cases. The books of the hospital that year show the admis- 
sion of 148 cases of yellow fever after the 1st of September, and 8^ 
deaths. 

In view of the facts just related, the term yellow, like the term con- 
gestive, as applied to fever, serves more properly to designate a condi- 
tion of the system or stage of disease, than any separate, distinct or 
specific form or kind of fever.* Symptoms which do not uniformly dis- 
tinguish a disease from all others before it has run its course, or until 
death is about to close the scene, are unworthy to be called diagnostic. 
During our late epidemic, all the forms of our endemic fevers were 
to be seen, such as intermittent, remittent, congestive, typhoid, &c., as 
may be seen by reference to the Statistics of Fever published in the 
last number of this Journal. 
At the Charity Hospitalise Admissions for Yellow Fever were 2811. 

Deaths " " " 895. 

Maison de Sant6. — (Private Hospital of Drs. Stone and Carpenter.) 
Admissions of Yellow Fever, 334. 
Deaths, " " " 34. 

These are extraordinary results. Heretofore, at the Charity Hospi- 
tal, the deaths from yellow fever have generally amounted to about one- 
half of the admissions. In this instance they do not amount to one- 
third. The great mortality that usually attends yellow fever at the 
Charity Hospital is not at all surprising to those who are familiar with 
this institution. It receives the lowest class of patients, a majority of 
whom perhaps enter after the third day of illness, and a large number 
in a moribund state. In addition to all this, it is impossible for patients 
in a large hospital like this, crowded as it necessarily is during an epi- 
demic, to receive those minute attentions so highly important when 
they are in a critical state. 

As the Maison de Santd is a private hospital and receives none but 
pay-patients, they must necessarily be of a superior class and have 
better attention. Nevertheless the success here presented is most com- 
mendable, and would be creditable in private practice. If these statis- 
tics be correct, they certainly substantiate the mild general character 
of this epidemic. At the commencement, the attacks were generally 
mild and yielded readily to treatment, but towards the last of August 
and first of September they were very severe. 

Extent and Mortality — The disease pei'vaded the whole extent of this 
city and Lafayette, also CarroIIton, Algiers, and down the river as far as 
the U. S. Barracks. In the family of Mr. Davis, at the Tobacco 
Warehouse, about three miles below Canal street, I saw five cases at 

* See the remarks of Dr. Brown, of Woodville, Miss., on the term " con- 
gestive," in the Third Volume of this Journal, page 443, 



Fbnner on the Yelloic Fever of New Orleans. 205 

one time. Dr. Wood, U. S. Surgeon at the Barracks, six miles below 
the city, informed me that he witnessed several deaths with black 
vomit in October.* 

As regards our own city, those quarters suffered the most which con- 
tained the largest number of recent and unacclimated inhabitants. 
Amongst these, the poorer classes, as usual, suffered the most, on ac- 
count of their manner of living, exposure to the exciting causes, im- 
prudence, &c. The Third Municipality, upper part of the Second, and 
back part of the city generally, having the largest number of small 
houses at cheap rent, necessarily contained the greatest portion of this 
class, and consequently suffered most. The central portion of the city, 
consisting of the First Municipality and lower part of the Second, hav- 
ing a greater number of acclimated and independent citizens, suffered 
least. The city of Lafayette, having fully doubled its population 
since 1841, was severely scourged. The localities around the two 
markets, St. Mary's and Poydras, in the Second Municipality, being 
densely inhabited by the lower order, were severely scourged. But it 
really appeared that the amount of sickness in different quarters was 
regulated more by the character of the population than by anything spe- 
dally pertaining to the locality. The population about New Orleans 
is proverbially restless and moveable ; hence many persons were taken , 
sick on their ipassage from the city — some on board of steamboats go- 
ing up the river ; others at the summer retreats across the lake, as 
Covington and Mandeville, Pass Christian, Pascagoula, Biloxi, «Scc. 

At Pass Christian several deaths occurred in persons who had re- 
cently gone over from the city ; but the fever did not spread among the 
numerous visitors there. At Covington it did appear to spread, accord- 
ing to Dr. Gilpin, whose communication is annexed. On the Missis- 
sippi river, cases were taken to nearly all the landings as high as 
Memphis ; but Rodney is the only place where the fever appeared to 
spread among the inhabitants, which we learn from Dr. Williams, 
whose paper will follow this. 

It is altogether impossible to estimate with any accuracy the number 
of cases of yellow fever that occurred in this city during the epidemic 
of 1847. By many it is thought to have amounted to twenty or twenty- 
Jive thousand ; but this calculation may be wrong. As there has been 
no extensive epidemic since 1841, and the population has been con- 
stantly increasing, there were doubtless more subjects for yellow fever 
than at any previous time. 

Mortality. — The number of deaths from yellow fever reported to the 
Board of Health by the sextons of the New Orleans cemeteries was 
2306. The number of interments from yellow fever in the Lafayette 
Cemetery, as published in the " National" a city newspaper, date 23d 
October, was 613. One of the New Orleans sextons neglected to re- 
port for two or three weeks. Many who died in this city were in- 



* Dr. W. being absent from his post. Assistant Surgeon Sloan has kindly 
furnished me with a communication on the subject, which will be appended t« 
this ajrticle. 



206 Tlie Epidemic Yellow Fever of 1847. 

terred in Lafayette and vice versa. I am inclined to think that 3000 
would not be short of the number who died of yellow fever, in the 
two cities. Amongst them there were tu'cnty-three natives of New 
Orleans — mostly children. 

The newspaper above referred to contains a catalogue of 2729 in- 
terments of persons who died of yellow fever, and were buried in the 
cemeteries of New Orleans and Lafayette, in 1847. This catalogue 
gives the date of burial, name, age and place of nativity. The fol- 
lowing classification of the ages at which death occurred may be inter- 
esting to the inquisitive reader. 

AGE. NO. AGE. NO. 

Infants, 3 50 to 60 years, 103 

1 to 10 years, 81 60 " 70 " 46 

10 " 20 '• 186 70 " 80 " - 14 

20 " 30 " 1098 80 " 90 " 3 

30 '-■ 40 " 671 90 " 100 " 2 

40 " .'iO " 250 Unknown, 269 

Total, 2729 ; of which 1954, or nearly ihreefourths were taken ofr between 
the ages of 20 and 40. 

Special 0BSERVATI0^'s. 

Second Attacks, <^c. — There were many instances of persons hav- 
ing the fever this year, who had had it before. Drs. Jones, Meux, 
Campbell, Picton, Beugnot and others have told me of cases whom 
they had attended themselves during previous epidemics. One of the 
worst cases that I saw recover this year occurred in an intelligent 
Irishman, who entered the Charity Hospital on the 2d of September, 
the fourth day of his sickness. He said he had had a raging fever 
for three days, attended with violent pains in the head, back, limbs, 
&c. The fever had then subsided ; he was turning yellow, and had 
hemorrhage from the gums. A better marked case of yellow fever 
was never seen. This man told me that he had come to live in New 
Orleans in 1824 — that he had an attack of yellow fever much like 
this in 1825 ; was attended by Dr. Ker, who pronounced it such — 
that he had lived here ever since, with the exception of 17 months 
spent in Mobile — and that he had enjoyed uniform exemption from 
fever during the whole intermediate time. He recovered and was 
discharged on the 12th of September. 

It is the general opinion here and elsewhere, that if a person have 
yellow fever once, he will have it no more, provided he continues to 
reside in yellow fever localities. Now, that a strong attack of this 
fever does effect a great degree of immimity from it in future, does not 
admit of a doubt ; but this is certainly not the case witli mild attacks. 
Nor is the immunity just allowed, to be compared with that eflected by 
an attack of small-pox, measles, whooping-cough or scarlatina, as I 
have heard asserted. 

Attacks among Creoles or JSatives. — The fever cannot be said to 
have prevailed as an epidemic amongst the Creole population. The 
adults may be said to have escaped the decided form of yellow fever 
almost entirelv, though I have been informed bv several extensive 



Fenner on the Yellow Fever of Neit Orleans. 207 

practitioners that they saw a number of strongly marked cases amongst 
Creole children under six yeai's of age. Dr. J. H. Lewis, who lives 
in the Third Municipality, and does an extensive practice amongst the 
Creole population, told me that he knew several Creole children to <Zze 
with black vomit during this epidemic. Many physicians here are of 
opinion that creole children, especially whites, are liable to yellow 
fever, but that it is generally so mild as to require .but little attention, 
and but for the occasional appearance of black vomit amongst them, it 
might pass for some other form of fever. It has just been stated that 
there were twenty. three deaths from yellow fever amongst the natives 
this year.* 

Negroes and Colored People. — All colored people recently settled 
in New Orleans are liable to have yellow fever, perhaps equally as 
much as white people ; but from some cause or other, the disease is 
certainly much milder amongst them. The number of attacks amongst 
negroes this year was very great, yet the mortality was extremely 
small. Mulattoes evidently sufiered much more than blacks. 

Escapes from the Epidemic. — Notwithstanding the general preva- 
lence of yellow fever in 1847, many persons who had but recently 
settled here and had never had the disease, escaped this year. On the 
other hand, there were instances of persons who had resided here a 
number of years, escaped all the epidemics subsequent to 1840, and 
had the fever this year. There are numerous instances of persons 
who have resided here 15 or 20 years, without ever having yellow 
fever. These facts go to prove that a person may by some years res- 
idence become just as secure against the disease as if he suffers an 
attack ; also that neither an attack nor acclimation will effect an inva- 
riable immunity. 

Treatment. — What shall I say under this head ? Such is the diver- 
sify of theory and practice pursued in yellow fever hy the physicians 
of New Orleans, that it would be altogether vain for me to attempt to 
delineate it. Suffice it to say, that every conceivable variety o^ prac- 
tice is pursued, fi'om the use of the most heroic remedies, down to a vir- 
tual dependance on the vis medicatrix naiur<s. The previous numbers 
of this Journal contain three systematic essays on the cause, nature and 
treatment of yellow fever, emanating from gentlemen who occupy the 
highest rank among the medical iaculty of this city — I allude to the 
papers of Drs. J. F. Beugnot, P. A. Lambert and J. Harrison. In 
these essays, all the prominent remedies that have been resorted to 
in the treatment of this disease are ably reviewed, and their merits 
and defects fairly stated, after having been fully tested, a hey will always 
be referred to with interest by the student of yellow fever at this place, 
and are particularly valuable as illustrating the views of the leading 



* Dr. Picton informs us that he really never was satisfied that yellow fever 
attacked Creoles, until this year, when one of his own children, a native of the 
city, came very near dying of it. The same with respect to second attacks, — 
he attended a case this year which he had attended before with well-marked 
yellow fever. 



208 The Epidemic Yellow Fever of 1847. 

French and American physicians of this city at the time. Of course 
many differ from these gentlemen ; but the difference is in minor 
matters. 

I deem it altogether useless to give the treatment which I pursued, 
but perhaps a brief allusion to a ie\w of the most prominent methods 
pursued by our physicians would be acceptable to the reader. 

In reflecting on the various remedies and plans of treatment in yel- 
low fever presented to my view in the course of a pretty extensive and 
careful observation at the Charity Hospital, in the walks of private 
practice, and in conversation with my medical brethren, I think the 
whole may be designated under the following two general plans of the- 
ory and practice, viz., the abortive and the rational or eclectic plan. 

1. The Abortive Method. — The object of this method is to qut short 
the fever as soon as possible. It was pursued by a few bold practi- 
tioners, who, however, resorted to very different means for its accom- 
plishment : one set relied almost exclusively upon hlood-letting, the 
other equally as much upon the sulphate of quinine. The hlood-letting 
plan is as follows : — as soon as the chilly stage is passed and reaction 
fully established, the patient is set up in bed and bled in a full stream 
to syncope ; a purgative enema and hot mustard foot bath are then ad- 
ministered. Reaction takes place, and when fully developed, the bleed- 
ing is repeated as before. And so on, as the reaction is strong and the 
patient can bear it. If the patient is unable to bear venesection, local 
depletion, by means of cups or leeches to the chief seat of pain, is 
resorted to. Some patients require to be bled four or five times, but 
generally not more than one or two free bleedings ; with perhaps some 
cups or leeches. No medicine is given by the mouth, — the bowels are 
kept freely moved by enemata. The foot-baths and sponging the body 
are repeated pro re nata, with cold drinks and light covering, complete 
the treatment. This is the depleting plan par excellence, as practiced 
by the late Dr. Luzenberg, Dr. Beugnot and a few other leading physi- 
cians below Canal street. There are others who follow this plan 
somewhat modified — they deplete all cases and freely, but they give 
medicines also. If the patient be of such a temperament or in such 
a condition that he cannot be bled, local depletion is depended on ; but 
these gentlemen look upon all such as have severe attacks and cannot 
hear the loss of blood, as being very dangerous. 

The Quinine Method. — In the essay of Prof. Harrison, previously 
alluded to,* may be found an interesting account of the introduction of 
large doses of the sulph. quinine in the treatment of yellow fever in 
this city, in 1839 and 1841. 

If 1 am not mistaken, the gentlemen who first adopted the practice 
still admit the wonderful powers of the medicine, though they have 
since fallen into more of an eclectic plan. Assistant Surgeon Charles 
McCormick and Dr. A. J. Wedderburn are the only physicians, so far 



* See Dr. Harrison's paper on Yellow Fever in the Second Volume, No- 
vember No. of this Journal — also Dr. McCormick's papers on the use of Qui- 
nine, &c., in the same Volume and Number. 



Fennkr on the Yellow Fever of New Orleans. 209 

as I know, who pursued this practice in its full extent, in the treat- 
ment of this e'pidemic. I shall therefore give their methods as ob- 
tained from themselves. As practised by Dr. McCormick, it is as fol- 
lows : — when the fever is fully developed, a purgative enema and mus- 
tard foot-bath are first used, and from 15 to 30 grains of quinine then 
given to subdue the fever. If the pain in the head is very violent, he 
is bled from the arm, or cups are applied to the mastoids ; otherwise, 
blood-letting is dispensed with. The larg-?, dose of quinine seldom 
fails to reduce the excitement in a few hours, and then he gives 15 or 
20 grains of calomel with or without as much of the quinine combined. 
The foot-baths and enemata are repeated pro re nafa ; the bowels are 
freely purged ; the fever vanishes, and the patient seldom requires 
more than the third dose of quinine. 

Dr. Wedderburn first orders an enema, consisting of a lable-spoonful 
of mustard in a quart of warm water, which he says evu'iuates the 
lower bowels more promptly and efficiently than anything else. Then 
comes the hot mustard foot-bath, and afterwards the following dose ; — 
^ Pulv. Rhei. grs. x, Pulv. Ipecac, grs. ii, Submuriat. Hydrarg. grs. v, 
Sulph Quinine, 9 i, mix in syrup and give at once. Sometimes he first 
gives 15 or twenty grains of quinine with 20 or 30 drops of laudanum 
suspended in water, and the above powder immediately afterwards. 
This purges freely in six or eight hours, and the quinine and laudanum 
are afterwards repeated according to the pain and fever. The purga- 
tive mentioned happened to be the one he mostly used last summer — he 
admits that some other might have done as well. This is his most 
general course, if the attack be very severe, and the patient suffers 
violent pain in any part, he at once gives from 20 to 30 grs. of quinine 
combined with 40 or 50 drops Tr. Opii, or 2 or 3 grs. of opium. Ac- 
cording to Dr. W. this dose rarely fails to extinguish both the fever and 
pain in a few hours. Drs. McCormick and Wedderburn both speak in 
the most exalted terms of their abortive methods of treating yellow 
fever. Dr. W. nex^er bleeds from the aim, and very seldom orders 
either cups or leeches. Other physicians here use quinine freely in 
yellow fever, but not like the above named gentlemen, to cut the fever 
short at once. 

There is one thing worthy of special notice in connection with this 
method of treating yellow fever, which is, that although the fever may 
be cut short, the disease is not always necessarily removed. Conva- 
lescence is not at once established; but the patient occasionally lingers 
in a feeble, though cool, quiet and painless state for some days, and then 
sometimes dies with black vomit. It would seem that the alterations 
in the blood, &c., produced by the morbific cause, still go on, to terrai- 
nate in health or death, although what is called the fever is extinguished. 
Dr. Harrison mentions this fact in his essay before mentioned, and it 
is well known to many of our physicians. It has been remarked, that 
even when the fever was not cut short by any potent medicine, but 
spontaneously subsided in 24 or 36 hours, as it sometimes does under 
the use of mild remedies, the prostration would be as great and the 
convalescence as tedious as if the fever had run its usual course for 72 
hours. Hence it is thought that the fehrific poison must be eliminated 
through the natural emunctories, before healthy reaction can be estab. 



210 The Epidemic Yellow Fecer of 1847. 

lished. With some, this might constitute a serious objection to the 
abortive melhod by quinine ; but it certainly is an important considera- 
tion to be able to relieve the painful and distressing symptoms, by a 
remedy which does not prevent the execution of any other indications 
that may arise. Nor can it be denied that when pain and febrile ex- 
citement are reduced, the system becomes much more amenable to the 
action of any remedies that nay be indicated. 

Under this view of the matter, I think the introduction of sedative 
doses of the sulphate of quinine may be considered a valuable improve- 
ment in our therapeutics of yellow fever. There evidently exists con- 
siderable prejudice against this method of using quinine, and we hear 
of physicians, bof.'i in this city and elsewhere, who state that they gave 
it a fair trial, and it did not answer their .expectations. For my own 
part, I think ic very doubtful v^'hether they have given it a fair trial — 
they are afraid of it — in short, they have not learned how to use it. 

As to the fact that patients are sometimes unexpectedly lost after all 
fever and pain are subdued. Dr. Wedderburn says that in all such cases 
as have come under his observation, it proceeded from the most culpa- 
hie imprudence. They are so promptly relieved of all pain and fever, 
that they do not allow sufficient time for the system to recover from the 
shock it has sustained. 

2. The Rational or Eclectic Method. — This method is founded on 
experience and rational observation, but independent of scientific induc- 
tion. The object of this method is not to cut short the disease, or take 
it entirely out of the hands of nature ; but rather to guide the patient 
through the natural stages of the fever, and to address proper remedies 
to the symptoms as they are presented. If blood-letting is plainly indi- 
cated, they bleed — if any particular organ seems to sufter most, they 
address their remedies chiefly to that, and so on. 

A rational eclecticism is the platform, to use a phrase that recently 
has come much in vogue in the politics of the day, on which the great 
body of the Medical Profession stand at the present day, in the treat- 
ment of most diseases. The very existence of specifics is doubted by 
many, and we have to be guided by general principles until we learn 
from experience the peculiarities belonging to diseases in difterent re- 
gions and localities, and the adaptation of certain remedies to meet 
these peculiarities. That different climes and localities do give striking 
peculiarities to the diseases which prevail in each, is almost universally 
admitted by those who had extensive opportunities for observation. 

Such being the object and views of the advocates of the rational or 
eclectic system, they go to work accordingly, each prescribing the rem- 
edies which he has found by experiment best ada'pted to meet the 
symptoms, and most of them falling into more or less of a routine. Nor, 
under these circumstances, is it surprising either that there should be a 
great diversity of practice, or that the. practice should vary in different 
places and seasons. The general practice in yellow fever pursued in 
New Orleans is not always the same, because the type of fever is not 
always the same ; and it generally differs from that pursued in Mobile, 
Vera Cruz, Havana, Charleston, Natchez, Vicksburg, &c., because 
each of those places presents some modification of the disease. It would be 



IDh. Fenner on the Yellow Fever of New Orleans. 211 

^most impossible to describe all the plans of treatment pursued by the 
rationalists in this city, but perhaps I may succeed in giving an outline 
of a few of the more prominent routines. 

I may state that venesection is used with great caution by the ration* 
alists — they foresee a stage of depression or exhaustion, that will inev- 
itably appear at the decline of the fever, and therefore endeavor to 
economise the powers of the system as much as possible. Cupping over 
the chief sufiering organs is much oftener resorted to. Mustard pedi- 
luvia are universally administered. In the first stage of the fever, a 
purgative of some kind is invariably administered. Some give an effi- 
cient dose of castor oil ; others prefer a mercurial cathartic ; others a 
saline. The bowels having been freely evacuated, local symptoms re- 
lieved and a general perspiration established, absolute rest and quietude 
are rigidly enjoined, and the fever is permitted to go on to its natural 
termination or crisis, which generally takes place on the third day. 
This is truly the critical stage of the disease, for the fate of the patient 
will soon be decided. He must either die or begin to recover very 
soon. A new set of symptoms are now presented, requiring different 
remedies altogether from those first used. Blisters, gentle stimulants, 
anodynes,] antacids, &;c., are now called in requisition and demand 
the utmost skill of the physician. Many patients are doubtless saved 
after getting upon the very verge of black vomit; but after this dis- 
charge becomes established, they are generally considered beyond the 
reach of medicine and have to depend upon the efforts of nature and 
the kind attention of the nurse. A variety of medicines have been re- 
commended for black vomit, but so far as I have been able to ascertain, 
not one of them possesses any reliable virtues. French brandy, porter 
and ice are depended on more than anything else in this stage, by 
the physicians in New Orleans. Some physicians, q,mongst them a 
few eminent practitioners, after relieving the first distressing symp- 
toms, by means of a purgative, the mustard foot-bath and cupping, 
put the patient at once on the solution of the sulphate or ferro-cyanate 
of quinine, 5 grains a dose every two hours, until the fever completely 
subsides. When the critical stage arrives, they treat it pretty much 
like those just mentioned. I cannot descend into the minutiae of prac- 
tice, but such is an imperfect outline of the practice pursued by the 
rationalists. As before stated, their object is not to cut short the dis- 
ease, but to guide the yatient safely through all the natural stages of the 
fever. 

There are, doubtless, cases which will prove fatal in spite of any- 
thing that can possibly be done. From the time the disease is de- 
clared, the patient is a doomed victim. He is either overwhelmed irre- 
sistibly at the outset, or the poison works its ravages so stealthily as to 
escape observation until it is too late for remedies. Witness the case 
of Dr. Dashiel, in which black vomit unexpectedly appeared whilst a 
man was getting shaved in a barber's shop, at Vera Cruz. I myself 
have seen a man lying quietly in his bed at the Charity Hospital, read- 
ing a book, whilst the fatal black vomit was already upon him. He 
seemed to be surprised at the minute inquiries I made about his case, 
and as I turned away, asked if I thought he was in any danger ? I 
gave him an equivocal answer, and left him in blissful ignorance. He 

27 



212 The Epidemic Yellow Fevev of 1847. 

resumed his story, and I saw him no more. The next hiorning he 
was dead. 

It has been shown that the most robust class of people and at the 
most vigorous age are the favorite subjects of yellow fever. Such per- 
sons do not complain at trifles ; they often pay but little attention to the 
first symptoms of disease, and only take to their beds when completely 
overpowered, thus losing the most important time for treatment and 
lessening their chances of recovery. Thus the hardy mechanic or out- 
door laborer is often lost ; whilst the more delicate, sensitive and pru- 
dent gentleman or lady is preserved. As to the amount of success 
attained by the followers of the rational method, it is impossible for 
me to state it. So far as 1 have been able to ascertain from some of 
the most extensive practitioners, it was at least very gratifying to them- 
selves. 

Ho7nceopathy. — I cannot close my remarks on the treatment of yel- 
low fever, without a brief allusion to a novel practice which has re- 
cently been introduced into our city, and like all novelties, has capti- 
vated some of our citizens. I allude to Homceopathy and its practice. 
In the autumn of 1846, Dr. Taft, apparently a modest, intelligent and 
genteel young man, came from the North and settled himself in New 
Orleans, to practise this new system of medicine, up to that time un- 
known in these parts. Having gone before the Board of Examiners, 
presented his diploma, (I know not from what medical college,) and 
obtained license regularly, he soon met with great encouragement and 
was really established into a lucrative practice at the time the epidemic 
broke out in the summer of 1847. As he was unacclimated, and of 
course might expect to be attacked, he was asked by a friend " what 
physician he would employ when he should be attacked with yellow 
fever ?" His reply was — " Dr. Taft." Sure enough, in the month of 
August he was severely attacked, and Dr. Taft being immediately on 
hand, was called on to attend Dr Taft. He at once resorted to his in- 
finitessimal doses of Homoeopathic medicines, and continued them until 
the end of the second day, when he became so ill, that his friends in- 
sisted on calling in medical aid, nolens volens. Two of the most re- 
spectable regular practitioners of the city were called in and did every- 
thing in their power to save him, but the precious time for active treat- 
ment had been lost, if not worse than lost, and he fell a victim to his 
own folly. 

With Dr. Taft died HamcRopathy in yellow fever for the season ; but 
the reports of his successful dehut Avent abroad throughout the land, 
and the vacancy created by the disappearance of " Yellow Jack " and 
Dr. Taft was soon filled by a host of Homoeopathic physicians, chiefly 
from the "land of steady habits." They seem to find much favor in 
the sight of the community during the healthy season of the year, but 
whether, like the martins, they will vanish when the "Dog star rages," 
remains to be seen. 

Hydropathy. — I heard of but one physician who pursued the hydro- 
pathic treatment, though there may have been others. Dr. S. W. 
Dalton, a regular licentiate, early in the epidemic fell upon the following 
simple method, with which he says he was so well pleased, that he pur- 



Dr. Fenner on the Yellow Fever of New Orleans. 213 

sued it throughout the season. As soon as the fever was fully devel- 
oped, and when the pains in the head and back were most severe,* he 
enveloped the whole body of the patient, from the neck to the thighs, 
in a thick bandage of cotton or linen cloth, and then placing him in a 
large tub, poured cold water upon his head until he became perfectly 
cool and thoroughly soaked. He says this never failed to remove all 
pain and make the patient comfortable. He was then put into bed, and 
the covering tucked closely about him. In a short time, he broke into 
a profuse perspiration and went to sleep. If the heat and pain re- 
turned, the cold water was re-applied. In the mean time, the bowels 
were freely opened with castor oil, cool drinks were given, and this 
constitutes the whole treatment. Dr. D. says he treated more than 200 
cases in this way, with the most gratifying results. 

As a part of the history of the epidemic, I give Dr. Dalton's staie- 
ment ; it may go for what it is worth. 

There were some other new systems of practice tried in this epi- 
demic by a few persons, who probably could attract attention in no 
other way than by some innovation. Among them was the system of 
Raspail, or the Camphor practice. It called forth some flaming puffs 
in the nevi'spapers, but I saw nothing of it myself, and only heard of an 
occasional case where an intelligent physician had ])een called to see 
an unfortunate victim who had thrown away his life by trusting to such 
nonsense. 

As to the extent of yellow fever up the river from this place, I may 
give the following memoranda, in addition to the papers of Drs. Cart- 
wright, Williams and Hicks, which are to succeed. 

There were several cases at the village of Plaquemine, also at Baton 
Rouge and Bayou Sara, but not enough to be called epidemic. I be- 
lieve no cases occurred at Grand Gulf. There was a pretty severe 
epidemic at Alexandria, on Red River. 

At Memphis, several cases were landed from the steamboats, but no 
person contracted the disease from them. One original case oc- 
curred at this place, the following notes of which were kindly fur- 
nished me by Dr. James Young. 

Case. — J. S., a silversmith, aged about 30 years, of a robust consti- 
tution and sanguine temperament. Had lived about Memphis some 
seven years — was taken sick on the 14th of September, soon after 
returning from the country, whence he had ridden 25 miles in a buggy. 
At first complained of something like a cold — felt chilly and had pain 
in the head, back and limbs. Dr. Young was called to see him on 
the 15th, and found him with a hot skin, eyes red and watery, tongue 
covered with a white fur and moist, pains, dec. His fever subsided on 
the fourth day of his illness. Then there appeared slight hemorrhage 
from the fauces and anus, with suppression of urine, and subsequently 
hlack vomit. He died in convulsions on the 21st September and 7th 
day of sickness. He had black vomit 36 hours before death. The 
corpse turned very yellow after death. 

Dr. Young having practised in one or two epidemics of yellow fever 
at Natchez, is familiar with the disease, and had no hesitation in pro- 



214 The Epidemic Yellow Fever of 1847. 

nquncing this a plain case. I see no reason to doubt the correctness 
of his diagnosis. 

Yellow fever prevailed to a considerable extent in our squadron at 
Vera Cruz and on the Gulf of Mexico. Surgeon Isaac Hulse, U. S. 
N., who is stationed at Pensacola, informed me that some interesting 
reports on the subject had been made to the Bureau at Washington 
City, by Passed Assistant Surgeon John Hornby and Assistant Sur- 
geon A. N. Bell. 

I have finished my task. I did not take up my pen to write a dis- 
quisition on yellow fever, but to endeavor to give some historical ac- 
count of the most extensive epidemic of that disease that has ever 
ravaged this city. I crave the indulgence of my Professional brethren 
in this city, towards any defects they may discover in my humble ef- 
fort. If they would do their duty, they would speak for themselves and 
not trust to the imperfect observations and representations of another. 
If I have done anything towards making up the medical history of th® 
times, the object of my labor is accomplished. 

I shall here append the following communication from Drs. 
Sloan and Gilpin, and afterwards those received from other pla- 
ces. It will be recollected that Dr. Gilpin's letter was published 
in the November No. of this Journal, under the head of " Health of the 
Country ;" but I think it proper to re-produce it here, by way of com- 
pleting the connection. 



Gekeral Hospital, New Orleans Barracks, 

July 27th, 1647. 

Deak Sir : — I send you, in accordance with your request, the only 
observations made upon the subject of the yellow fever last j^ear, by 
Surgeon Wood, U. S. A., that are on record at the Hospital. You will 
perceive from his remarks that a separate report upon this subject was 
forwarded to the Surgeon General's office, at Washington. No copy 
0r« this report is on file here, except one of my reports to Dr. Wood, 
S ept. 30th, 1847. This I send you, but fear it will be of little service. 

I would remark, that nearly all the persons attacked in Hospital 
were under treatment at the time for some chronic disease. The only 
exception, I believe, to these cases was that of a woman, an Hospital 
Matron, who died from black vomit. She had not been sick previously, 
kept away from the city, but was exceedingly fearful of an attack of the 
fever. 

My own opinion of the fever can be given in a few words. I be- 
lieved it yellow fever, modified by the less virulent condition of the 
cause that existed in the city. Our location seemed to be on the outer 
circumference of a poisoned circle, where distance, perfect ventilation, 
and the best internal and external police rendered less violent the et 
fects of the predisposing cause. I do not believe that the disease as it 
existed hero was contracted in the city. 



Dk. Fenner on the Yellow Fever of New Orleans, 215 

. Accompanying this, I send you a rough estimate of the number of sick 
in this Hospital during the months the fever prevailed in New Orleans, 
with the proportional number of cases of yellow fever. 

Very respectfully and truly yours, &;c., 
WILLIAM J. SLOAN, 
Assistant Surgeon, U. S. A. 
Dr. E. D. Fenner, New Orleans." 

Extract from Surgeon Wood's Quarterly report of Dec. 31st, 1847. 

" In September and October many cases of yellow fever occurred, 
some mild and some exhibiting malignant symptoms, as black vomit, 
&c. No fatal cases occurred before the 1st of October. The small 
number of cases reported and the large number of deaths, is to be re- 
ferred to the fact that the fever attacked many who had been registered 
and under treatment for other diseases." 

Report made to Surgeon R. C. Wood, U, S. A., by Aassistant Surgeon 
Sloan, Gen. Hosp., N. O. Barracks, Sept. 30th, 1847. 

"The cases of fever that have come under my observation at this 
post during the prevalence of yellow fever in New Orleans, have differed 
from the ordinary fevers of this climate. These cases were character- 
ized by the suddenness of the attack, the short duration of the tever, 
and great subsequent prostration. Persons were seized, without any 
premonitory indisposition, with violent rigors, followed by fever, with 
intense pain in the head, loins and limbs ; the eyes were suffused. 
These symptoms yielded readily to treatment in twenty-four or forty- 
eight hours, leaving the patient extremely debilitated. I have no hes- 
itation in ascribing these attacks to a modified condition of the poison 
of yellow fever in the atmosphere — modified in a ratio corresponding 
to the distance from its centre of action in New Orleans, and rendered 
comparatively harmless by the excellent police of the hospital and gar- 
rison, and the care observed in preventing exposure to the sun and 
transitions of temperature. 

Fever of a similar type has prevailed in other localities near the 
city. In my own case, the attack differed from any I ever experienced. 
In Capt. Fenner's family, (all of whom were attacked,) the disease was 
remarked to be entirely dissimilar to the fevers of North Alabama, their 
former residence. I should hesitate in denominating these attacks yel- 
low fever, since they were wanting that train of violent symptoms so 
characteristic of the disease, that tend to the very disorganization of the 
body ; yet, at the same time, I must believe them a type of the disease 
modified as before mentioned. 

In regard to the treatment adopted, it Avas simple and effectual. 
Submuriat. Hyd. gr. xv, followed by 01. Ricini, was administered at the 
commencement. Frequent mustard pediluviee and the free use of warm 
drinks were very beneficial in promoting free diaphoresis. After the 
violence of the fever had abated, Sulph. Quinine, grs. xx, once or 
sometimes twice a day, were administered with good effect, without the 
necessity of further repetition. In some cases, after free purgation, 
when the fever had not abated, where there was still pain in the head. 



216 



The Epidemic Yellow Fever of 1847. 



with a quickened pulse and dry skin, twenty grains of Quinine were 
beneficial and followed by perspiration during the day ; the remedy was 
repeated with good effect. In one or two cases, I gave the Quinine 
and Calomel in combination, with good results. The local symptoms 
were relieved by cups to the temples, sinapisms to the epigastrium, ice 
to the forehead, &;c. Total abstinence from solid food and perfect rest 
were strictly enjoined. 

Whole number of sick in General Hospital, N. O. Barracks, for the 
months of July, August, September and October, 1847, with the num- 
ber of cases of Yellow Fever, and deaths therefrom : — 



Months. 


No. of sick ill 


Cases of Yellow Fever. 


Deaths f m Yel. Fever.| 


Hospital. U Months. 


No. 


Months. 


No. 


July, Aug- 
ust, Septem- 
ber and Oc- 
tober. 


411 


August, 1847 
September " 
October " 
November " 

Total 


2 
9 

8 
1 

20 


October 8 
" 12 
" 18 
" 21 

November 10 

Total 


2 
2 
1 
2 

1 

8 



Dr. GUpiii's Letter. 

"Covington, La., October 22nd, 1847. - 

"In answer to your letter of the 18th, which I did not receive in time 
to acknowledge by return mail, I take the earliest opportunity of re- 
plying to. 

"Several families of Germans and Dutch, u'ho have resided in Neia 
Orleans two or three years, came over here the latter end of August to 
escape the fever in New Orleans, and took possession of some unin- 
habited houses. About the fifth day after their arrival, one man was 
taken sick ; from what I can learn, no physician saw him for two days ; 
he died the fourth day, with black-vomit. In the meantime another man 
and his wife (also emigrants) were taken down and both died in a 
similar way. After a day or two, two of our citizens who had been 
with the sick, and attending on them, were also taken down with a 
similar attack; and after this the disease spread generally through the 
immediate neighborhood where it is thickly inhabited ; from this it 
spread through the town, except that portion where I reside, which is 
separated by a small branch from the town. We have all kept well. 

"I may safely estimate the number of cases from 160 to 180; out of 
which, with other diseases, there have been eleven deaths, one of 
which was from consumption, and ten of fever. 

"I have seen eleven cases from New Orleans, who were taken sick 
either immediately on their arrival, or within a day or two after, some 
at Madisonville, some at Lewisburg, and some here ; those cases have 
not varied in the slightest degree from the patients I have attended here, 
I do not think it genuine yellow fever. The persons have generally 
been attacked severely ; the fever has commonly been subdued in thirty- 
six hours, but has left the system very much exhausted. In my own 
practice in the place, I have lost only one patient — that from relapse, I 



Williams on the Yellow Fever of Rodney, Mississippi SI? 

have not bled in any instance, have only given Calomel to one person, 
and only cupped one — I have relied entirely on external applications, 
castor oil, injections and quinine. 

"There have been several instances of persons coming from the coun- 
try to the town on business, several of vi^horn soon after have been at- 
tacked with fever, and generally have died, mostly of black- vomit. 

"The fever has entirely subsided here for the last five or six days. In 
haste. J* Cr." 



n — On the Yellow Fever of Rodney, Miss., in the year 1847, by 
W. G. Williams, M. D. 

To E. D. Fenner, New Orleans. 

Dear Sir : — Your letter of the 13th of December last was duly re- 
ceived, but owing to various circumstances I have been prevented from 
replying soonei'. As I shall be compelled to be brief, I will endeavor 
to confine myself to a simple reply to your interrogatories, without in- 
dulging in any speculations on the subject of yellow fever, except so 
far as the nature of your inquiries may demand. 

"Interrog. 1st. At what time did yellow fever make its appearance at 
your place, and what were the prevailing diseases immediately pre- 
ceding it ?" 

Ans. It is my opinion that the first individual who died of yellow 
fever was a man who returned to this place from New Orleans, sick, 
about the 18th or 19th of July, 1847, and who died on the 23d. As 
respects the health of our town it was good at this time. This applies 
to the surrounding country as well as to the village itself. 

"Int. 2nd. What was the condition of the place at the time, in a hygi- 
enic point of view?" 

Ans. I have not observed any change of importance in this respect 
since 1837. Our place was, I think, in as cleanly a condition as it 
ever is during the summer and fall seasons. As regards this locality, 
I refer you to a letter furnished you on this subject, and published in the 
first number of this Journal, (May No. 1844.) 

"Int. 3d. Please describe the commencement of the disease, its pro- 
gress, general features, and decline. Did it disappear before frost ?" 

Ans. As I have already observed, I believe the first death from the 
disease occurred on the 23d of July. On the 27th of this month and 
on the 11th of August, two individuals were taken sick in the same or 
an adjoining room. These were his attendants. One of them, a white 
man, informs me he was confined about a week ; had fever, but does 
not know what was the matter with him. This man was taken on the 
27th July. The other, a negro woman, it is said had an intermitting 
form of fever. I did not see either of them while sick. Between this 
time and the 27th of August, some whites and a number of blacks, were 
sick in this immediate vicinity. On the night of the 30th of August I 
was called to see a man in this part of the town, and found him dying 
of hemorrhage from the bowels. He had been complaining of indispo- 
sition a few days, took his bed on the 27th and died of yellow fever on 
the 30th, with hemorrhage. An individual who was in his room when 



iJl8 Tlie Epidemic Yellow Fever of 1847. 

I saw him, and much about him during his illness, was the next pftrsoii 
I was called to see, sick of this disease, and this was on the 2d of Sept. 
On the 6th of this month I visited a gentleman, who resides in a distant 
part of the town, but is confined by his business to that part of the vil- 
lage where the lever cases occurred. 

I will here state that in 1843, the first case of yellow fever occurred 
at the other extremity of the place, and that the disease for some days 
was confined to the family, in which this case occurred and their at- 
tendants. This has been the case, I think, this season. It was very 
circumscribed in its operation for a length of time, and confined to the 
immediate vicinity of the first case. On the 8th, we concluded we were 
on the eve of an epidemic, and by the 15th the disease pervaded the en- 
tire place. 

On the morning of the 8th or 9th, I was called to see a man who had 
been ailing for some time, and who was supposed to be jaundiced. He 
was able to walk about his room at the time I saw him. His tongue 
was clean. His hands were cold. His pulse thready. His counten- 
ance was expressive of both despondency and indifference. His intel- 
lect seemed clear, but when interrogated, he replied in a deliberate, 
and abstracted manner. He became delirious on the evening of the 
day I saw him, and died with black vomit the day following. The next 
person I was called to see, was a man who was much with the individu- 
al above alluded to and occupied the next house. The progress of this 
case was rapid, as black vomit made its appearance in 3t) hours from 
the commencemt of attack. Up to this period, we had much conten- 
tion respecting the true nature of the disease, but the circumstances of 
this case, particularly the vomit (which was the unmistakeable coffee 
grounds) convinced the most skeptical. The disease was characteriz- 
ed by the same general features as in 1843. No one who had the dis- 
ease here in 1843 took it this season, and very few, probably not more 
than five or six who never had the disease, escaped. This is as true 
of our negroes as of our white citizens. The disease ceased for a time 
before frost, the mornings became very cool, and frost was reported to 
have been seen. This induced a number of our citizens to return, 
several of whom took the disease. This occurred as late as the 9th 
of November. 

"Int. 4. Had you any quarantine regulations ? If so, were they rigidly 
enforced, and with what benefit ?" 

Ans. No quarantine regulations have ever been established at any 
time at this place. 

"Int. 5. Do you believe the fever originated in your place, or was it 
brought there? Give the grounds of your belief." 

Ans., I do not believe that this disease originated here from local 
causes exclusively; some of my reasons for this belief, you will find in 
my reply to your first, third and next interrogatories. 

"Int. 6 Did you see any evidences of the contagiousness or infec- 
tiousness of the disease ?" 

Ans. I think so ; and in addition to what I have already said touch- 
ing this point, I will state a circumstance that occurred in a family I at- 
tended. A man with a family consisting of a wife and two children, 
left the place, and removed five miles into the country. He took pos- 



Williams on the Yellow Fever of Rodney, Mississippi. 219 

session of a small cottage, containing two small rooms. A man who 
was in his employ, left the village about the same time, and took one 
of these rooms. The man and his wife and two boys occupied one 
room, and this individual the other. This man took the disease on the 
6th day after leaving Rodney, and died on the 8th. The family waited 
on him during his illness, and four days after, the two boys took the dis- 
ease. They had been twelve days from town, and must either have 
carried the seeds of the disease with them when they left, or contract- 
ed it from the man who died in the adjoining room. Of many who 
fled and where sick in the country, none took the disease after the 6th or 
7th da}--, except these two boys. The mother had the disease before 
she left the village, and the father on his return to it, after the recovery 
of his sons. 

"Int. 7. Did you see any instances of other forms of fever running into 
yellow fever, or the reverse ?" 

Ans. I saw a case that resembled in some of its features congestive 
fever, and I think might have been mistaken for that form of disease. It 
seemed to me to partake of the nature of both congestive and yellow 
fever, corresponding in all respects to neither. I feel confident that 
the two diseases were blended in this case. I saw one individual who 
had intermittent fever, with some of the symptoms of the prevailing epi- 
demic, and another who during convalescence had a periodic fever. Are 
not intermittence and remittence attributable to a physiological condi- 
tion rather than to the action of a special cause ? Do not various dis- 
eases assume these types, and why may not yellow fever? The phenom. 
ena that constitute what we understand by the term fever, are the 
same in small-pox, scarlatina, measles, yellow fever and bilious fevCf. 
Fever I apprehend to be nothing more than an expression of nerVo. 
vascular irritation. A man has a chill ; reaction comes on and we 
have a condition that we designate by the term fever. After a while an 
eruption makes its appearance, and constitutes it a case of small-pox, 
measles, or scarlatina; or the distinguishing marks of yellow fever may 
present, and we have a case of this disease. All these may assume an 
intermitting or remitting type. So far as the phenomena that consti- 
tute /etJer are concerned, they are the same in all ; and I have witness- 
ed as much diversity of opinion, and seen as much difficulty in christening 
measles, scarlatina and small-pox, as yellow fever. 

"Int. 8. What remedies or course of treatment did you find to be most 
efficacious ?" 

Ans. The only material difference in our treatment of the disease 
during this epidemic and that of 1843, consisted in the more liberal 
use of quinine ; which was attended with very satisfactory results. 

"Int. 9. Have you ever seen any cases of the ordinary endemic fevers 
of your vicinity terminate in hemorrhage and black vomit ?" 

Ans. I have not. 

I have thus hastily endeavored to comply with your request ; and I 
assure you, that nothing but a disposition to oblige you has prompted me 
to the task. Very truly, yours, 

WM. G. WILLIAMS. 

Rodney, Miss., February 10, 1848. 

23 



220 The Epidemic Yellow Fever of 1847. 

III. — On the Yellow Fever of Vicksburg, Miss., in the year 1847. By 

B. J. Hicks, M. D. 

To Dr. Fennek, New Orleans. 

Dear Sir : — Your letter of the 20th ultimo, in which you make in- 
quiiy in regard to the history of the epidemic fever which prevailed in 
our city during the past autumn, has been received, and with pleasure I 
furnish you wiih such facts as came immediately under my own obser- 
vation. The hygienic condition of our town was such as would most 
certainly produce disease. The months of July and August preceding 
were unusually warm, the thermometer ranging from 90 to 94^^ in the 
shade, with frequent showers of rain succeeded by sudden bursts of sun- 
shine. In a pcjrtion of the city there were many old uninhabited wood- 
en buildings in a state of decay, with foul contined air between the 
floors and in the cellars, which must necessarily have been very in- 
imical to health. The attention of the city authorities was urgently 
and repeatedly called to these sources of disease ; but nothing was 
done to correct the evil ; every hope and trust being placed in the es- 
tablisment of what they considered a rigid quarantine ; and whilst all 
were relying upon this shadow, and sleeping as they supposed in safety, 
the leaven of destruction was ripening from the putrid exhalations 
emanating from undoubted causes existing directly amongst us. 

Our diseases until the 30th of August were of a mild intermittent 
character, but as soon as the burning rays of a southern sun had done 
their work, we had presented to us a fever of a most malignant char- 
acter, proving fatal in most ot the cases that occurred until a northern 
blast stamped a milder feature upon the face of the epidemic. 

It is the opinion of many of our most experienced physicians that if 
the condition of the atmosphere had continued as in the commencement, 
we should have had a most devastating epidemic, more fatal perhaps 
than that of 1841 ; and that we were indebted to the Ruler of the ele- 
ments for the mild character which the disease suddenly assumed as 
soon as the wind changed to the north ; thus modifying the poisoned air 
and rendering it [ess nocuous to man. 

The first case of yellow fever occured on the 31st day of August, 
at the house ot Terrence Owen, in the north-eastern portion of the 
city, remote from the river, in the person of James Trynor, a young 
Irishman of temperate habits and good constitution. When first called 
to see him, I found him complaining of violent pain in the head; he stated 
that he felt as if an iron band had been drawn tightly across his fore- 
head, insupportable pain in the back, aching of the joints, universal 
soreness of the Hesh, as if he had been beaten with sticks, eyes 
highly injected, constij)ated bowels, great irritability of stomach, re- 
jects everything taken, also mucus with occasional flocculi resembling 
small particles of blood subjected to the action of muriatic acid. These 
symptoms continued with but slight abatement until the 4th of Septem- 
ber, under the most prompt and energetic treatment, such as repeated 
cups to the nucha and epigastrium, ice to the head and hot mustard 
pediluvia every four hours, active enemas, aperients of massa. hydr. 
and ext. colocynth. compound. Irritability of stomach still existing — a 
blister plastcrlO by 10 inches was applied over the epigastrium, and aa 



Hicks on the Yellow Fever of Vicksburg, Mississippi. 221 

soon as vesication was produced, the cuticle was ordered to be re- 
moved and blister dressed morning and evening with ^ gr. of morphine 
and 10 grs. sulph. quinine — free suppuration was encouraged by dressing 
with the unguentum resinosum. On the 6th of September a favorable 
change took place. The patient gave evidence of the violent concus- 
sion the system had undergone during the progress of the disease, pre- 
senting a dusky lemon hue over the whole surface, which first com- 
menced over the chest and around the mouthy quickly extending itself 
over other portions of the body. About the 9th of September the pa- 
tient was discharged cured, convalescence being both complete and 
rapid. 

A few days after Trynor sickened I was invited by my valued friends 
Drs. Broadnax and Balfour, physicians to the city hospital, to examine 
the body of a patient, Hugh Wilson, who had just expired in that chari- 
table institution ; of which invitation I availed myself. About fiv6 
hours after deaths in the presence of Drs. Nutt and Magruder and 
Messrs. Ford and Brown, medical students, I proceeded to make a post 
mortem examination. 

The body presented a surface of a dark lemon hue, interspersed with 
dark colored spots. A black fluid had issued from the mouth, resemb- 
ling coffee grounds. The stomach was of usual size, mucous coat high- 
ly injected, many of the vessels to the extent of being ruptured — of soft 
consistence — contained aboiit ^ x of a dark colored fluid, with granu- 
lated particles resembling coffee grounds which did not color watei* 
when mixed with it, but would settle at the bottom of the vessel, leaving 
the water perfectly clear. The small intestines contained a dark col- 
ored fluid similar to that found in the stomach. Mucous coat inflamed, 
but to a less extent than that of the stomach. Large intestines con- 
tained a fluid resembling the sediment of port wine ; mucous coat in- 
jected ; of a more florid red than that of the stomach and small intes- 
tines. Nothing remarkable about kidneys, except presenting a yellow 
tinge. The liver somewhat softened in consistence, the great lobe of a 
spotted yellow color ; left lobe of a more regular orange hue ; gall 
bladder distended with a dark tenacious fluid, of the consistence of tar* 
Throat and head not examined. 

Wilson had been engaged in laying brick in ihis city for some months 
previous to his illness ; had no communication with any vessel ascend- 
ing the Mississippi river; had not visited any sick person for some 
Weeks; neither had he seen, or been near the quarantine depot. He 
Was admitted into the hospital on the 3d day of September, and died on 
the 6th. The history of his case I have not been able to procure. 

Whilst returning from this tri[> of investigation, my friend Dr. Mag- 
ruder informed me that he had a patient laboring under a similar dis- 
ease, the Rev. Dr* Teavel, whom on the following day I was called to 
see. I found him laboring under incipient black vomit and in a sinking 
condition. He expired the next morning, after throwing up large quan- 
tities of this fluid. He had been for some time engaged in the duties of 
his station, in holding a protracted meeting, and had not been near the 
quarantine depot, steamboat landing, or visited any sick person for some 
weeks. His residence was in the centre of the square upon which the 
old uninhabited buildings in a decaying condition spoken of above were 



222 The Epidemic Yellow Fever of 1847. 

located, and immediately north of an old theatre which had been a short 
time previously torn down and removed by order of the city authorities, 
disengaging large quantities of poisoned air which had been the pro- 
duct of fermentation for years, which no doubt was wafted by the south- 
ern breezes directly into his bed chamber and thus in part poisoned his 
system. Several other cases occurred upon the same square, simultane- 
ously with that of Dr. Teavel ; a Jewess, Henry Wirtz, and Mrs. Jane 
Porter, all of which terminated fatally; the first and last about the 5th 
day of the attack, the second lingered for several weeks, having relapsed. 
Not having been physician to the foregoing cases, I cannot give the 
history and treatment, but only mention them as being interesting in 
connection with the origin of the disease, not one of them having had 
any intercourse with steam boats, quarantine depot, or even been absent 
from the city for months previous, and up to this period no person sick 
of yellow fever had been permitted to enter our city. The attentive 
health officer strictly and faithfully discharged his duty. The fatal ten- 
dency of the disease produced great alarm and excitement amongst our 
citizens, many left their homes and fled for safety to the country. But 
in a few days the wind shifted to the north, and the fever assumed a 
milder type, which caused many of our citizens to return to their homes 
and resume their daily occupations. 

On the 19th of September I was summoned to visit Daniel Mont- 
gomery. I found him complaining of severe pain in the head, eyes high- 
ly injected, pain in the back and lumbar region, soreness of the flesh, 
constant aching and tired feeling in the extremities, great irritability of 
stomach, vomitting incessantly. 

TreaiinenL — V. S. § xx, pills of blue mass and comp. ext. colocynth, 
which were immediately rejected ; twelve leeches applied to the epi- 
gastrium, active enema ; ice to the head and hot mustard pediluvia every 
four hours. 

10th — Patient still restless, stomach irritable ; enema had acted three 
times ; complained of violent pain in the eyes and forehead ; irritability 
of stomach still very distressing. Blister plaster 10 by 10 ordered to 
epigastrium, leeches to the temple, iced gum water for drink, mustard 
pediluvia ordered to be repeated. 

11th — Irritability of stomach still continues ; distress insupportable ; 
throws up large quantities of mucus ; entire absence of. bile; blister 
had drawn well; remove cuticle and dress with niorph. and sulph. quinine. 

12th — Patient passed comparatively a quiet night ; pulse 90 ; skin 
soft; morph. and quinine dressing continued. 

13th — Black vomit ; appeared to be sinking ; ordered enemas of cam- 
phor grs. V and quin. sulph. grs. x, every four hours, in mucilage. This 
prescription arrested the vomiting, but as soon as the vomiting ceased, 
the patient complained of partial loss of vision and delirium. 

14th — Pulse full and regular ; skin soft and moist ; tongue furred in the 
centre, with red edges ; hemorrhage from the nose and gums ; total loss 
of sight; cannot distinguish a bright sunshine from the darkness of a 
clouded night ; eyes had the appearance of being natural with the ex- 
ception of slight dilitation of pupils and an injected condition of the con- 
junctiva. Blisters ordered to the temples and nucha, suppuration of 



Hicks 07i the Yellow Fever of Vicksburg, Mississippi. 223 

the blistered surface on the epigastrium encouraged by dressing with 
the unguentum resinosum, brandy toddy and arrow root. 

15th — Pulse more feeble ; hemorrhage from the bowels ; subsultus. 
Camphor and sugar of lead enemas ordered every four hours ; brandy 
toddy and arrow root continued. 

From this time the patient continued to sink gradually from the ex- 
hausting hemorrhages from the nose, gums, bowels and urethra, until the 
24th, when he expired, after having been sustained by the extraordinary 
means adopted after the appearance of black vomit — I am of opinion 
that the patient would have sunk on the 5th day of his attack had he not 
been sustained by the camphor enemas. I have never witnessed 
a recovery after the appearance of black vomit, except by the camphor 
treatment. 

On the 29th day of September, I was called to see Thomas McCon- 
Tiel, whose residence was on the same square as that of Dr. Teavel. I 
found him entirely delirious ; could not keep him in bed ; pulse 128, full 
and hard ; violent pain in the head and back; eyes highly injected; 
great restlessness ; aching feeling in the extremities ; universal sore- 
ness of the flesh. Ordered blood-letting 3 xxx. ^- massa hydr. comp. ext. 
colocynth. u a. "^ i., make 8 pills. Take four at once, four in three hours ; 
ice to the head ; hot mustard pediluvia. 

30th — Pulse 100, skin soft, medicine had acted twice ; tongue red on 
the edges, furred in the centre ; pain in the back ; tired, aching feel- 
ing in the extremities. Ordered cups to the epigastrium ; warm mustard 
bath, mucilaginous drinks. 

Oct. 1st- — Patient spent a restless night ; suppression of urine ; epis- 
taxis; irritable stomach; rejects every thing taken. Ordered the fol- 
lowing enema. ^. spir. turpentine 3 ij, Tr. assafoet. 3 ij, mixed in 
§ iv. mucilage; blister plaster to the epigastrium. 

2d — Hemorrhage from gums and nose ; irritability of stomach sub- 
siding, slight passage of urine, enema had acted once ; patient restless; 
remove cuticle from blister ; dress with \ gr. sulph. morph. and grs. x of 
sulph. quinine, morning and evening. 

3d — Hemorrhage from gums and nose very much increased ; con- 
siderable hemorrhage from blistered surface, so much so as to wet the 
patients bed with blood. Dress blister with 4 grains sulphate of iron, 
grs. X. sulph. quinine and ^gr. sulph. morph. 

4th — Exceessive hemorrhage from the gums, nose and bladder, univer- 
sal yellowness of the skin, pulse small and frequent ; nearly suflbcated 
with the bleeding from the gums whilst sleeping ; bloody froth issues 
from the mouth ; friends suppose him to bodying. Blister dressed with 
sulph. quJn. and sulph. ferri.; ice to the head ; sinapisms to the ex- 
tremities. 

5th— ^Slight improvement ; patient more rational ; slept calmly seve- 
ral hours ; hemorrhage still continues from nose and gums ; morph. and 
quinine dressing for blister with the ungentum resinosum ; this readily 
caused suppuration which invariably improves the gastric symptoms. 
The quinine and morphine dressings were continued until the 8th, when 
the patient was discharged cured and, as was generally the case, con- 
valescence was rapid. 



224 The Epidemic Yellow Fever of 1847. 

Blood letting, cupping or leeching, mustard baths, enemas and thd 
endermic use of quinine and morphine in the advanced stage of yellow- 
fever, have proved more successful than any other course of treatment 
adopted by the pliysicians of this city, so far as the writers observations 
have extended. In fact, in all cases in which the stomach, the main 
citadel, has been taken possession of by disease, the endermic use of 
remedies is the principal reliance for a successful issue of the case, and 
deserves the consideration of the profession. Many patients have been 
hurried out of existence, by crowding an already irritated stomach with 
nauseous drafts. I have related the three cases above, to give some idea 
of the general character of the disease, but the greater number of the 
cases were of a much milder type. All cases were initiated with the 
same symptoms, differing in degree ; some would readily yield under 
the milder remedies, other cases would assume a more malignant or 
typhoid character. In the mild cases, there was an early appearance of 
a prickly heat eruption, which was a sure indication of a speedy con- 
valescence. This eruption never occui'red in the malignant or typhoid 
cases, but occasionally fine petechise, which I supposed to be an effort 
of nature to throw the eruption to the surface. But her powers being 
too feeble, she failed to accomplish her design. All cases of disease 
ran into the epidemic type. The yellow fever commenced at the close 
of the month of August. In the course often days it had become deci- 
dedly epidemic, prevailing to a very great extent. Nearly all of our 
citizens felt its influence, though the disease had become remarkably 
mild, not more than three per centum proving fatal. 

The disease subsided about the 25th of October, at which time we 
had a slight frost, though a few sporadic cases occurred until the 10th 
of November, when all nature was clothed in ice. 

Our city has been visited with epidemic yellow fever during the years 
1841, '43 and '47. That of 1841 was of a most malignant typhoid 
character, one case out of every four proving fiital under the best treat- 
ment. The epidemic of 1843 was more limited, of decided inflammatory 
symptoms, and less fatal ; about one death in six. The epidemic of 
1847 may be properly styled mild epidemic yellow fever, being remar- 
kably easily managed, and only about 25 deaths out of nearly 800 cases. 
In consequence of the mild character of the disease, many doubted 
whether it was yellow fever or not, and some difference of opinion ex- 
isted amongst the physicians, as was the case in 1841, until nearly 200 
of our citizens had been taken to the burying ground. Nearly all of 
the cases that terminated fatally, closed with' black vomit, except 
those in Avhich excessive hemorrhages occurred. I have never wit- 
nessed black vomit in the endemical fevers of our vicinity, but have often 
met with miasmatic fevers of a heavy grade in which hemorrhages 
from the nose, gums and bowels were not unfrequent in the closing 
stage of the disease. 

From all the facts that we can gather from the history of yellow fever 
as it has heretofore prevailed in this city, we have not been able to 
trace a single instance in which it showed the least disposition to mani- 
fest a contagious character. 

In 1837, when the city of Natchez was laid waste by its devastating 
influence, numerous cases in every stage of the disease, from the initiary 



CARTvviaGiiT on the Yellow Fever of Natchez, Mississippi. 225 

symptoms to the black vomit point, were landed from boats and ushered 
into crowded filthy boarding houses, with ten or a dozen in a room, and 
in not a single instance did a nurse or attendant become aifectcd with 
the fever, though many of those landed died with black vomit. Such 
was the case in 1839 — the writer attended numerous cases that were 
landed from boats from Natchez, our city being then crowded with pau- 
pers who were flying from disease and contagion as they supposed, as 
is usual in our southern cities when an epidemic breaks out ; but in no 
instance did he witness any disposition to contagion. 

In 1841 many citizens fled from Vicksburg when the epidemic was 
declared to exist. A large portion of them sickened at different points, 
and many died; Judge Anderson in Bolivar county. Dr. Wellcr and his 
son in Raymond, Messrs. Vail and Davenport in Clinton, all of whom 
had numerous attendants and in no instance did any of their friends or 
nurses sicken with the disease, notwithstanding they all died with black 
vomit, the ripe stage of contagion, if contagion could be. 

During the past season, in vain did the advocates of contagion look 
for a source of disease from importation. They asserted that Dr. Teavel 
had visited the quarantine depot and had thus taken or contracted the 
disease, and that Trynor did not have yellow fever because he did not 
die. But it was ascertained that Dr. Teavel had not been within a 
mile of the quarantine landing since its establishment. The evidence 
of local origin was so plain that the advocates of contagion became 
quiet, our city authorities suspended the quarantine regulations, com- 
merce resumed her sway, the resounding echo of the signal cannon re- 
lapsed into silence and steam boats were permitted to glide to our wharfs, 
all being satisfied that we were suffering the penalties of sanitory neg-- 
lect. Your friend, 

B. J. HICKS. 

Vicksburg, Mississippi, January 20th, 1848. 



IV. — On the Yellow Fever of Natchez, Miss., in 1847. By Samuel 
A. Caktwkight, M. D. 
De. Fennek, 

Dear Sir : — I have just returned from a three-month's tour to the 
North, for the benefit of my health and to pick up medical information, 
and I find among my letters one from you so tar back as the 17th of 
December last, which I now proceed to answer. 

In regard to your questions about yellow fever of last year, I have 
to inform you that we had in Natchez only a few sporadic cases. 

I was called to see Mr. Haffner, a German, from the Rhine, who 
had been living in this city for a year or two, and had always been 
healthy — a tailor by trade. He had not been out of town during the 
summer, nor any where among the sick. He resided in a low, con- 
fined place, and the back yard was very dirty. He died on the fourth 
or early on the fifth day, with genuine yellow fever, on the 2d. of Octo- 
ber. I saw another case which died on the 0th of November, on the 
third day. He was a stout Irishman — had not been out of town or any 
I 



•326 The Epidemic Yellow Fever of 1847. 

where to contract the disease. He lived in a close, confined room, and 
dirty, ill-ventilated back-yard ; his name was O'Rourke.. He lived 
in a different part of the town from Haffner, and a month or more oc- 
curred between the two cases. These were the only two cases I saw 
in town ; but some three or four other sporadic cases occurred. A 
German woman died in October of yellow fever, and my overseer, also 
a German, living on my plantation, G miles from Natchez, in La.,, 
went to see the woman with yellow fever when he was exposeti to the 
same local causes which gave it to her. Late in October last I visited 
New Orleans. On my return, Mr. Grejer, my overseer, I found had 
died, during my absence in N. Orleans, with yellow fever. Black vomit 
very copious and frequent. None of my negroes nor any of the per- 
sons who attended him took the disease ; nor did any of the persons 
living near O'Rourke and Haffner take it. The reason why 
so few had the disease, I attribute to the fact that most of our 
people are acclimated and are not susceptible to it. For instance, 
we had the lever in the epidemic form in 1837 and 1839, and ial844 
we had a good many straggling cases. We have kad little or no ac- 
cession to our population since, and consequently no subjects for it. We 
have had what is called a quarantine, and may attribute our exemption 
since 1839, (1844 excepted,) to the quarantine. Those persons trace 
^r pretend to trace the cause in 1844 to Woodville or your city, and not 
being able to trace the cause of last season to any foreign origin, they 
:doubt whether the cases above stated were yellovt^ fever. I tkink there 
is no doubt of it.* In fact, for the last twenty-five years, I have seen 
cases of yellow fever almost every year, originating, as I believe, here 
under some strong local or predisposing causes. 

In one of your questions, you ask if yellow fever disappears before 
frost ? I have known it to continue for some weeks after frost, when 
it begins late in the season — and quit before frost when it begins early. 
I have seen many cases after several frosts. The quarantine regu- 
lations were not rigidly enforced. People would land on the other side 



* In confirmation uf the testimony here given by Dr. Cartwright, in regard 
to the eifeets of quarantine at Natchez, I will add the followiBg memoranda^ 
kindly furnished me by Dr. James Young of Memphis, Tennessee, a talented 
and accomplished physician, who resided in Natchez in 1844. Tiiey are given 
in his own words. F. 

"Natchez, 30th September, 1844, 

Called to see Dr. Craig this evening at 7 p. m. The Doctor informed me 
he had been sick three days. October 1st. — He commenced throwing up black 
vomit at 6 o'clock, p. m. 2d — At 5 o'clock, a. m., threw up black vomit, 
again at 7 o'clock, and died at 10 o'clock, p. M. Dr. Craig was seen by Dr. 
Cartwright and Dr. Davis. 

fcsamuel. R. Hammitt, attacked with yellow fever 19th October, — sick five 
days. — Recovered. 

T. Cranch, attacked with yellow fever 28th October, — sick ten days. — Ke- 
covered. 

The three cases of yellow fever occurred in Natchez, when the city was 
generally healthy. 

Neither of the patients had been where the disease was prevailing, nor had 
either of them seen any individual laboring under the disease. J. Y." 



McCrAVEn on the Yellow Fever of Houston, Texas. 337 

of the river and cross over in the Natcliez ferry boat, or below town 
or above the quarantine ground. One of the landing places was hu- 
morously called the upper quarantine. 

5th and 6th Interrogatory. — I believe the yellow fever originates in 
Natchez. From 1825 to '35 we had no quarantine, and the yellow 
fever was imported into Natchez almost every year, but it never spread, 
and no one ever took it from the patients themselves. The boats some- 
times seemed to be infected. 

9th Interrogatory. — "Has yellow fever prevailed at your place before?" 
Yes— epidemically in 1817, 1819, 1823, 1825, 1837, 1839. A few cases 
almost every year, and a great many cases in 1829 and 1844— but not 
epidemic. 

I have, in answer to your 10th question, seen a few cases of the 
ordinary fevers terminate in hemorrhage and black vomit,* without 
being, as I thought, yellow fever, properly so called. Yellow fever I 
take to be a disease separate and distinct from bilious fever. It gives 
a peculiar expression of countenance to the patient. It is I believe ari 
American disease. If contagious, it is not more so than the common 
bilious fevers. All fevers are more or less contagious, and all dis- 
eases for that matter, in one sense of the term, as they vitiate the 
atnlosphere. 

Very respectfully, your obedient servant, 
' SAMUEL A. CARTWRIGHT. 



V. — On the Yellow Fever of Houston, Terns, in 1847. By WiLiiAM 
McCeaven, M. D. 

Houston, Texas, Jan, 12, 1848. 
Dear Sir : — I did not receive yours of the 10th ultimo, till about 
the 1st instant, and take pleasure in furnishing in reply such information 
as the data in my possession will permit. In answer to your first in- 
terrogatory : The first case of yellow fever occurred here on the 4th 
of October. A case of rather doubtful! character had occurred four days 
previous and was then on hand. As it excited a good deal of interest 
here, and, as I think, there can be little doubt that it was yellow fever, 
at least in the end, I will give some account of it. Mr. V. had been 
indisposed at Galveston for three or four days. Yellow fever was then 
prevailing at Galveston, though not admitted to be epidemic. He had 
two or three light fevers then, as he informed me, and took some pur- 
gatives and quinine, but most of the time was actively and laboriously- 
employed. He arrived here on the evening of 30th September. He 
had fever that night, but was up in the morning, and took dinner with 



* The fact here stated by Dr. Cartwright, is confirmed by Dr. Thomas 
Fearn, of Huntsville, Ala., and Mr. W. P. Hort, of this city, two distinguished 
physicians now retired from the practice. I obtained their testimony in recent 
interviews with these gentlemen. I myself have seen cases of bilious fever 
terminate in fatal hemorrhage from the mouth and bowels, though not black 
vomit, in Hinds Co. Miss. I might differ with Dr. Cartwright as to yellow 
fever being " a disease separate and distinct from bilious fever,"' — but will take 
aorae other occasion to argue the point. F. 

29 



228 The Epidemic Yellow Fever of 1847. 

some appetite. In the afternoon he was taken with rigors and violent 
pain in the head, back and extremities, attended with fever. In this 
condition I was called to prescribe for him. He was alarmed and rest- 
less — thought he had yellow fever and was apprehensive of the result. 
His pulse was a good deal accelerated, quick and compressible — his 
skin hot and dry — his eyes suffused and red, tongue moderately coated 
with whitish fur, and red on the tip and edges. The symptoms were 
strongly indicative of yellow fever. But the proceeding symptoms — the 
decided remissions which had evidently occurred — the time which had 
elapsed since fever first made its appearance, threw doubt on the case, 
and rendered a diagnosis uncertain. It was evident to me he was not 
in the 4th or 5th day of yellow fever. I enquired if his eyes had been 
previously inflamed. He told me they had been red and somewhat in- 
flamed, but had gotten well. 

I regarded the case as doubtful, but determined to treat it as yellow 
(ever. The fever continued with little abatement until the third day. 
The pains were mitigated, but not relieved entirely. On the 4th day, 
fever was almost gone, but I did not think him entirely free till the 6th. 
The skin and eyes were decidedly icterose. He was desponding and 
very nervous. Dozed a good deal and muttered in his sleep, which was 
light and interrupted. Often changed his position. For about 24 hours 
he appeared much improved. Tongue cleaned off" — had some appe- 
tite and read a newspaper. Skin moist and heat well diffused. His 
gums had been bleeding a little for a day or two. On the evening 
of the 4th he had an operation which showed appearances of blood. 
He rested tolerably well and had no further movement till next mor- 
ning, when his discharge consisted almost entirely of blood, but with- 
out any pain, except a little uneasy sensation just before a movement 
took place. The tongue became healthy in appearance. The ex- 
tremeties continued warm ; skin moist, and pulse very little above the 
natural standard, ranging from 80 to 90. In despite of all remedies 
the hemorrhage continued, and he died on the 10th, retaining his 
mental faculties till a few hours before his death. Indeed, for a day 
or two previous, his mind appeared less clouded than in the earlier 
stages of his illness. I was informed by one of his attendants, that 
just before he died he threw up black matter, which was probably black 
vomit ; but as I did not see it, and the attendant had never seen black 
vomit, I am unable to speak positively upon the subject, 

This was probably a case of yellow fever supervening on ordinary 
remittent, and was almost an exact counterpart of a case, the first 
which originated here in 1844. 

On the morning of the 5th Oct., I was called to see Mrs. W. 
She was taken the evening previous with chilliness, attended with 
fever and excruciating pains in the head, back and limbs. I saw her 
in this condition. There was but little redness in the eyes. In the 
evening she was better. She complained of ringing and exceedingly 
disagreeable feeling in her head, from the effects of quinine. Next 
morning she was free from fever, and continued so, notwithstanding 
the excitement and distress she passed through afterwards. This was 
a slight case, though the symptoms were severe at first. If it had 



McCraven on the Yellow Fever of Houston, Texas 229 

occurred alone, I should not have regarded it as yellow fever. I have 
seen such however. 

Mr. T., her brother, was ill in the house at the same time ; he wastaken 
with the same symptoms on the morning of the 4th. Sick 24 hours 
when I saw him. His eyes were quite red ; pulse frequent, quick and 
compressible ; tongue fiery red on the edges and tip, partly coated 
and partly as though it had been scalded and the epithelium peeled 
off; restless and thirsty. His was a well-marked case of yellow fever 
of a bad type, and as his constitution was very delicate, I augured un- 
favoi-ably of its termination. It did not run a regular course however. 
Fever declined gradually, but did not leave him till the 6th day. His 
tongue at one time had been very dry and almost black, especially on 
the denuded portions, became moist and looked well. He had become 
very yellow— had some appetite and no thirst. He was cheerful, and 
I thought almost out of danger on the 10th. But that night he grew 
worse. I found him on the morning of the 11th, much to my surprise, 
with dry hot skin, great thirst and restlessness ; tongue again dry. He 
died on the evening of the twelfth, with all the characteristics of yellow 
fever, including black vomit, which occurred just before his death. 

Mr. W., of very feeble constitution and nervous temperament, was 
taken oh the evening of the Gth, two days after his wife, with severe 
symptoms. Fever abated on the 3d day. Got out of bed and lay on 
the sofa. Being a self-willed, obstinate man, with some very strange 
notions, he did just what he pleased. Amongst othef imprudences, he 
ate some very indifferent water-melon. On the 10th, he dressed him- 
self and went into the adjoining house, as his own family were all sick, 
and he wished to be quiet. On the 11th, he went to his store and re- 
mained til] evening. This was the Gth day from his attack. He re- 
turned home and spent a restless night. In the morning I found him 
in bed, perspiring freely ; surface warm, pulse about 60, and of pretty 
good strength. He appeared strange and very slow of comprehension. 
He gradually became more and more stupid — complained of nothing — 
had no fever, and extremities warm — drowsy — sleep troubled — mutter- 
ing — eyes half closed. He became unconscious towards evening and 
very restless, often attempting to get out of bed, and requiring consider- 
able force to restrain him. Skin and eyes yellow. He died on the 
night of the 13th, eighth from the attack — did not vomit after his re- 
lapse. 

Miss W., daughter, and Miss T., sister of Mrs W., were taken on 
the 7th with same symptoms, but of milder character. Miss W.'s fever 
lasted two or three days, and left her languid and listless for several 
days. Her eyes were very yellow ; her skin of a dusky reddish hue, 
as though the superficial capillaries were congested — a circumstance 
which I have frequently observed in yellow fever. And hence, proba- 
bly, arises the great danger of exposing convalescents to a draught of 
cool air before the system has had time to recover from the shock. 
The power of generating heat is so feeble that the system will cool 
down under the influence of a current of cool air, almost like an inani- 
mate substance. I came near losing a patient under such circumstances 
in 1844. All symptoms of the disease had disappeared. He was lying 
between two windows and had fallen asleep without cover. He was 



830 The Epidemic Yellow Fever of 1847. 

almost as cold as a corpse and nearly pulseless, yet seemed unconscious 
that anything was wrong. It took an hour or two of the most active 
stimulation external end internal to rouse him. No serious incon- 
venience seemed to follow. But to return to my subject. Miss T. had 
▼ery little fever after the first day, and indeed not much then, but like 
all the rest, was chilly and had intense pain in the head. She insisted 
for a day or two that nothing else was the matter. For several days 
her stomach was very irritable, and most that she threw up was of a 
grass green color. She and Miss W. both recovered, but were much 
debilitated for several days. Had Miss T's case occurred alone, I should 
not have regarded it as yellow fever ; but occurring as it did with four 
others, ail at the same time, in fact every member of the family was 
down at once, I could not but consider it of the same character with 
the rest. She was not much jaundiced. A young man who had been 
boarding in the family was taken about the same time — said to be yel- 
low fever. I did not see him. They were all unacclimated. 

On the 20th and 22d, two cases occurced in (he adjoining house— r^ 
fever with rigors at the commencement ; violent pain in the head, back 
and limbs ; red watery eyes ; fever abating on the third day, with 
much debility ; skin and eyes yellow — in fact, regular cases of yellovy 
fever throughout. Both recovered. These are fair samples of the 
cases as they came under my notice. They were not numerous at any 
time in my practice. It could not, I think, at any time be fairly re- 
garded as an epidemic, and the best evidence of this fact I think was, 
that our ordinary fevers prevailed at the same time and greatly pre- 
dominated over the yellow fever cases. This was not the case in 1844. 
In August of that year, I scarcely met with a case of fever that did not 
distinctly present the features of the epidemic. From about the time 
of the last mentioned cases till the middle of November, a good many 
scattering cases were reported. Quite a number of Germans, recently 
arrived and settled around the suburbs of the town, died. What pro- 
portion had yellow fever I do not know, as they were mostly attended 
by German physicians, who I think did not regard the cases as yellow 
fever ; but whether they were familiar with the disease or not, I am 
unable to say ;- — can only speak of two cases which I was requested 
by some charitable ladies to visit, as the family had not much confi- 
dence in the attending physician. I was at the time informed that one 
of the patients was throwing up black vomit, and it was not expected 
that anything could be done for him, but something it was hoped might 
be done for the other case. When I called one was just dead, and 
while I remained, the other threw up black vomit and died next 
day. I was informed that the other had vomited matter of precisely 
the same appearance, and from the signs which I saw, I have no 
doubt it also was black vomit. The attending physician, I believe, 
though I had no conference with him, called the cases congestive fever, 
at least I so understood from the father, an intelligent German, who 
could speak a little English. From these cases I supposed that pro- 
bably a good many of the Germans had died of yellow fever ; but this 
is only a supposition. The cases among the American part of our 
population were not numerous, but the deaths in proportion were con- 
siderably greater than in 1844. I saw one case, a black, on the 1st 



McCraven on the Yellow Fever of Houston, Texas. 'iSl 

of December, which bore a strong resemblance to yellow fever. I 
would observe here, that some authors, I believe, deny that the 
blacks are subject to the epidemic, which is undoubtedly a mistake. 
They were subject to it here both in 1839 and 1844. I attended a 
number the latter season, as well-marked cases as any I saw. The 
disease, however, according to my observation is seldom fatal with 
them. The prevailing disease at the time that yellow fever made its 
appearance, was ordinary remittent or bilious fever, which, as I before 
observed, continued to prevail throughout the season. Dysentery had 
been more than usually prevalent for the last year. In the preceding 
winter, typhoid fneumonia prevailed and proved fatal in a good many 
cases, especially among the blacks. During the past twelve months 
I have had some six or eight cases of typhoid fever, the first I have 
met with in Texas : all in children under 12 years. They continued 
from 15 to 30 days. All but one recovered. In the early part of sum- 
mer, also, we had a remarkably large number of cases ui jaundice, of 
which I suffered myself, much to my surprise, as 1 was at the time of 
my attack in perfect health, not having been confined to bed a day 
since I had yellow fever here in 1639. It has appeared to me that 
for some years all our diseases were becoming more and more ataxic. 
I seldom meet with cases in which the lancet or any other mode of 
depletion can be judiciously employed to any great extent. Mercury, 
too, perhaps for the same reason, I find a very doubtful remedy in fevers. 
In fact, I seldom now employ it in fever, except in combination with 
mild purgatives, given occasionally in small quantity. 

I have already answered your 1st and ;5d questions. 

2d. The town was in a tolerably cleanly condition. It js situated on 
the border of a flat prairie, and although there is no marsh in its im- 
mediate vicinity, the prairie is so level, that with the exception of that 
portion of the town near the bayou, it drains slowly. It is, however, 
much better drained now than tbrmerly ; and the soil is of such a na- 
ture, that when well drained, it dries rapidly. Our prevailing winds 
blow over the open prairie about a mile before reaching town. On the 
north of the town, the country is timbered for three or four miles, and 
our north winds are always regarded as unfavorable to invalids, par- 
ticularly in the fall season. If not attended with rain, they are remark- 
ably dry , and in summer hot. 

4th. We have never had any quarantine establishment. 

5th. The question whether yellow fever is of foreign or domestic 
origin, is one on which I have never been able to satisfy myself fully. 
I am not a partizan of any particular theory on the subject, but have 
diligently sought for facts on which to base an opinion. I was until 
last year strongly inclined to the belief, that with us it was always of 
foreign origin. In 1839 I was here, but not professionally engaged. 
I had the disease about the 22d ol October. It prevailed then in a ma- 
lignant form. It commenced, I think, about the 1st of September and 
continued till near the last of November. Our population was then 
probably less than 3000, and \ think there could not have been less 
than 200 victims to the epidemic. The town was then in a remarkably 
filthy condition. It was crowded with persons out of employment and 
(^eptitute of means, many of them intemperate. When taken with the 



23 '2 The Epidemic Yellow Fever of 1847. 

fever, they had neither the necessary comforts nor the means to procure 
them, and sickness was so general that it was exceedingly difficult for 
a stranger to get proper attention even if he had money. It is not sur- 
prising that many died. I cannot speak positively respecting the first 
cases which occurred then, but think they came from New Orleans. 
Such I know was the impression on my mind at the time, but 1 caimot now 
recall the grounds on which it was based. This was the first appearance 
of yellow tever in our town, and it prevailed very generally, as but few 
of our citizens had had the disease, and most of those who had not, 
were attacked. It did not disappear till long after frost. Frost always 
I think operates as a check upon yellow fever, but if warm weather 
sets in atterwards and continues long, the epidemic will revive again 
and may be as bad as ever. A good frost I believe destroys the 
cause. 

The second appearance of yellow fever in this place, was in July, 
1844, and of this epidemic I can speak with confidence, as I was 
actively engaged professionally through the whole of it, and several, 
of the first cases were under my charge. The first case arrived from 
Galveston, on the 10th of July, I think, and placed himself under my 
charge — he was then in the third or fourth day of his attack, without 
fever, but very nervous and greatly debilitated. He continued so for 
several days and recovered. I had three or four other cases under 
similar circumstances — -all having taken the disease in Galveston and 
come up in the boat. About the last of July I had a case which 
occurred in town and ran a course precisely parallel to that of Mr. W. 
cited above, and terminated in hemorrhage and death. In this case 
yellow fever seemed to supervene on another disease. About this time 
I saw a case of black vomit incidentally, but as the patient was not 
under my care, I do not know its history. About the 1st of August 
cases began to appear frequent, and in a few days the epidemic be- 
came general and spread rapidly through town, the cases from Gal- 
veston appearing to act as foci of infection. By the 1st of September 
it had nearly exhausted itself in the densely populated portions of 
town, but lingered about the outskirts for another month and disap- 
peared long before frost. The latter part of the fall was healthy. 
During its prevalence, scarcely any other form of disease manifested itr 
self Few unacclimated persons escaped, and none to my knowledge 
(and I made diligent enquiry) had the epidemic who had suffered a pre- 
vious attack. The epidemic was comparatively mild, and the proportion 
of deaths small, though it presented a malignant aspect at Galveston. 
The fever ran from one to three days, and although it left the sufferers 
"weak and exhausted, convalescence v/as generally rapid and complete 
in a few days. Black vomit was not a very common symptom even 
in fatal cases. Death I believe seldom ensued before the sixth or 
seventh day. The town was in a much better condition than in 1839, 
but worse drained and less cleanly than at present ; and there is still 
great room for improvement. 

As to the origin of the fever here the last season, all the facts seenj 
to point directly to a domestic origin. I could trace no connection 
Jjetween the family of W. and any other case of yellow fever. Mr, 
v., it is true, had been sick four days when the two first cases of ye]<i 



McCraven on the Ycllou; Fever of Houston, Texas. 233 

low fever occurred ; but they occurred in a distant part of the town, 
one of them in a female who seldom went out, and I can trace not the 
slightest connection between them and V. The only plausible mode 
by which it could be traced to a foreign origin, would be to ascribe it to 
goods received from abroad, (VV. and T. being merchants,) but this I 
think extremely improbable. On a careful review of all the circum- 
stances, I can come to no other conclusion than that it was local in 
its origin. 

6th. I have never believed yellow fever to be strictly speaking con- 
tagious. But I have frequently thought I could trace evidences of in- 
fection. My experience the last season has added to these evidences, 
yet I will not pretend to aver that they are not all deceptive. It is 
certain, however, that in nearly all the cases that occurred for two or 
three weeks, a connection either direct or indirect with the W. family 
could be traced ; for instance, at least six of the attendants had the 
fever and another who visited the family once or twice, had it. A 
young man and his two sisters visited and watched with them regularly. 
He was present when T. died, and asked me if the attendants were 
liable to take the disease 1 I told him I thought they were more likely 
to do so than others, but that if he was taken ill and would take medical 
advice at once, I thought he need not feel any alarm, as he was accus- 
tomed to a hot climate. In a few days, he and both his sisters passed 
safely through the fever. The physician who attended -these cases 
was unacclimated ; he was soon after taken with the fever and died. 
Two persons at least, who visited the house while he was ill, had the 
fever and one died. The iady in whose house Mr. W. died and her 
daughter were taken about a week after his death ; — both recovered. 
A woman who assisted in nursing the W. family soon after died with 
black vomit. Not long afterwards, her husband also died of yellow 
fever, as was said ; but I do not know whether he had black vomit or 
hot. It is at least remarkable in a season, when so few cases occurred, 
that so many of them should have had intercourse with yellow fever 
patients, and in fact I could trace such intercourse in every case which 
came to my knowledge for several weeks. It is true, that all the un- 
acclimated who had intercourse with the sick were not attacked ; but 
I believe most of them were. The evidence which I have been able 
to collect is strong in favor of some kind of infection, growing out of 
intercourse with the sick. The more strictly I have scrutinized the 
matter, the stronger has the proof appeared. 

I give you the facts for what they are worth. 

7th. The case of V. I regarded as a different form of fever, ter- 
minating in yellow fever. 1 also met with a case, the first I saw 
originating in town in 1844, and to which I have already referred, as 
terminating in the same way. I have also met with some cases in 
which yellow fever ended in a slow remittent form of fever, which 
lasted 8 or 10 days. These cases, however, have been rare. 

8th. In reference to the treatment of yellow fever, the cases which 
occurred in my practice last year were so kw that I would be un- 
willing to deduce any general rules of practice from them. There- 
fore, most of what I have to say upon this subject will be based upou 
my experience in 1844, which was ample, and I think successful, as I 



'^34 The Epidemic Yellow Fever of 1847. 

did not lose more than two patients, whom I visited the first day ; and I 
attributed most of the deaths which I witnessed to too active purgation with 
drastic medicine. There is a strong tendency in the epidemic to localize 
itself on the bowels. Strong purgatives seemed greatly to increase this 
tendency. Such cases I always found very intractable. I doubt the 
efficacy of the mildest purgatives in yellow fever, and am strongly in- 
clined to believe we would be more successful without them^ I have 
seldom used the lancet in yellow fever — not in any case last year-^ 
though in 1844 I bled two or three patients with manifest benefit. 

I have a good deal of faith in quinine in the incipient stage, and pre.* 
fer giving it freely during the first 24 hours. I have little faith in mer- 
cury. I give it in small quantity in the commencement of the attack — 
usually a few grains of blue-mass; I do not, however, rely much upon it. 
I order a warm bath ; general if convenient, if not, a hot mustard bath 
to the feet — followed by flying sinapisms, often repeated. Cups dry 
or wet "pro re nata to the nucha, temples, epigastrium and spine— ^ 
wherever in fact there is much local pain. I generally give a mild 
aperient in the beginning, assisted by an enema, if the bowels are cos- 
tive, lam not, however, satisfied, as I before remarked, that Ihis pur-' 
gative plan, however mild the means, avails anything in most cases of 
yellow fever. It is hard, however, to overcome the prejudices of peo- 
ple in its favor. I usually find the bowels easily moved. If the skin is 
dry, I give some diaphoretic, as liquor ammoniae acetatis with spt. nitre, 
nitrate potass, and a little sulphate of magnesia in mint water as a men- 
struum, and if the stomach is not irritable and pulse rather full, add a 
little antimony or ipecacuanha, to reduce Hs action and determine to 
the surface. I have the stimulating pediluvium often repeated and also 
the sinapisms and stimulating frictions, and if there is much heat about 
the head, ice or cold water constantly applied till the action of the heart 
is reduced. If there is tenderness of the epigastrium or abdomen, af- 
ter cupping I apply a large warm poultice, which I think generally far 
preferable to blistering. I prefer warm drinks, genes-ally, but there are 
some cases in which cold drinks are perhaps preferable, and I allow 
patients frequently to swallow ice in small quantities, if the thirst is 
urgent, and especially if there is much irritability of stomach. My 
main reliance is in a good active intelligent nurse — full doses of quinine 
till the system is brought well under its influence — the frequent and 
diligent use of external stimulants and cupping according to circum- 
stances. When a remission takes place, if the patient takes it with a 
relish, I generally give brandy ad libitum, till some strength returns. I 
believe brandy is the best stimulant we can give and most agreeable to 
patients generally. But I think I have seldom found benefit from its 
use unless the patient took it cheerfully — and on the other hand, when 
he took it with a relish I have almost universally found it serviceable. 

I have some confidence in small doses of saline medicinces, and fre- 
quently give them more as an alterative than to act on the bowels. The 
blood is undoubtedly in an altered state in yellow fever. The salinei 
principles are said to be in defective quantity. I think it extremely 
probable that in this and other fevers where that condition of the blood 
exists, the neutral salts are of much more value than is generally sup=i 
posed among us. It is certain that they are much more extensively 



McCraven on the Yellow Fever of Houston, Texas. 235 

used abroad than among ourselves. The pathology of yellow fever, 
(perhaps of all fevers,) is, I think, involved in a great deal of obscurity. 
The gastro-enteritic theory is to me an absurdity. It is evidently mis- 
taking an occasional effect for a general cause. I do not believe that 
either gastritis or enteritis generally exists in yellow fever; and if any 
case can exist without either, it is unphilosophic to regard them as the 
esssential cause. Whether the change in the blood, before referred to, 
is antecedent to the commencement of fever, I am unable to say. Dr. 
Stephens, I believe, contends that it is. If this be true, (and I think it 
might be very satisfactorily tested in your city,) it will throw a great 
deal of light on the pathology of fevers. I have been fully satisfied 
ever since I had the disease myself, that the first sensible lesion was in 
the brain and nervous system ; and it is probable that the lesion of the 
ganglionic nerves is owing to that softening of the mucous membrane 
of the stomach which has been so generally, and as I think, erroneous- 
ly regarded as the sign of inflammation. The black vomit, I am satis- 
fied, is not an effect of inflammation of the stomach, but is the dissolved 
blood which has fermented the softened tissues of the stomach and been 
blackened by the chemical action of the acid there encountered. 

The cause of yellow fever, then, whatever it be, must act in one of 
two ways — either when absorbed into the system it changes chemically 
the qualities of the blood, and thus contaminates all the different organs, 
the most sensitive, to wit, the brain and nervous system, suffering first ; 
or it acts directly on the brain and nerves in the first instance, and from 
this primary lesion results the derangement which follows in the other 
organs. But I must bring this long letter to a close, which has been 
written in moments snatched from other engagements, and often inter- 
rupted, so that I fear you will find it very desultory and unsatisfactory. 
If you find any thing in it which shall aid you in the laudable task you 
have imposed upon yourself, or if at any time I can furnish you with 
facts or information that may assist you in your literary pursuits, it will 
be a source of much gratification to give you all the aid in my power. 

Yours, very respectfully, 

WILLIAM McCRAVEN. 

Di{. E. D. Fknnrk. 



LIBRftRY OF CONrPccc- 

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